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GIFT  OF 


A  Dietary  Study 

OF  SOME  KANSAS  INSTITUTIONS 
UNDER  CONTROL  OF  THE  STATE 
BOARD    OF   ADMINISTRATION 


By  E.  H.  S.  BAILEY 

Professor  of  Chemistry,  University  of  Kansas 
Chemist,  State  Board  of  Health 


PRINTED    BY    KANSAS    STATE    PRINTIWO    PliANT 

B.   P.  WALKER,   STATE   PRINTER 

TOPEKA      1931 

9-575 


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A  Dietary  Study 


OP 


SOME  KANSAS  INSTITUTIONS  UNDER  THE 

CONTROL  OF  THE  STATE  BOARD 

OF  ADMINISTRATION 


BY 

E.  H.  S.  BAILEY 

Professor  of  Chemistry,  University  of  Kansas 

Chemist,  State  Board  of  Health 


I'KINTFD    Br    KAXSAS    STATE    PRIXTIXfl    PLANT 

B-  P.  WALbEU,  Statk  Printer 

TOPEKA       10  21 

9-575 


!^ 


CONTENTS, 


PAGE 

Introductory   5 

I.    Kansas  State  Penitentiary,  Lansing 8 

II.    State  Industrial  Reformatory,  Hutchinson 16 

III.  Osawatomie  State  Hospital 23 

IV.  Girls'  Industrial  School,  Beloit 31 

V.    Topeka  State  Hospital 37 

VI.    State  Hospital  for  Epileptics,  Parsons 45 

VII.    State  School  for  the  Blind,  I^ansas  City 53 

VIII.    State  Training  School,  Winfield 58 

IX.    State  School  for  the  Deaf,  Olathe 63 

Comparison  of  Dietaries  of  Nine  Kansas  Institutions 68 


468088 


LETTER  OF  TRANSMITTAL. 


Lawrence,  Kan.,  September  1,  1921. 
To  the  State  Board  of  Administration: 

Gentlemen — In  accordance  with  your  request,  I  am  trans- 
mitting herewith  the  abstract  of  my  report  on  the  dietaries  of 
some  of  the  state  institutions  under  the  control  of  your  board. 
Respectfully,  E.  H.  S.  Bailey. 

(4) 


A  Dietary  Study  of  Some  Kansas  Institutions. 

By  E.  H.  S.  Bailey. 


INTRODUCTORY. 

The  importance  of  dietary  studies  has  only  been  recognized  for  the 
past  seventy-five  years.  The  people  of  the  United  States  have  been  re- 
garded as  generous  feeders,  as  we  grow  all  the  food  that  we  really  need 
and  have  an  excess  to  export  to  the  nations  abroad.  The  question  as  to 
the  food  of  the  individual  becomes  more  complicated  when  applied  to 
large  groups  of  people,  as  to  boarding  schools,  reformatories,  orphanages 
and  hospitals.  Questions  as  to  the  quality,  the  quantity  and  the  cost  of 
foods  furnished  to  such  large  units  of  people  are  constantly  arising. 

In  order  to  study  this  understandingly  we  must  first  consider  how 
food  nourishes  and  sustains  the  body.  The  food  is  used  in  two  ways: 
First,  to  build  up  and  repair  body  tissue;  and  second,  to  furnish  the 
body  with  the  energy  required  to  maintain  vital  processes  and  for 
muscular  work.  We  are  familiar  in  general  with  the  fact  that  the  pro- 
tein or  nitrogenous  foods,  such  as  meat,  milk  and.  eggs,  are  needed  to 
build  up  the  tissues,  and  that  fats,  or  butter  and  oil,  and  carbohydrates, 
such  as  cereals  and  sugar,  are  needed  to  furnish  the  energy  for  work. 

It  is  only  within  a  comparatively  few  years  that  we  have  been  able 
to  measure  dietaries  in  a  scientific  manner.  Following  the  European 
chemists,  Prof.  W.  O.  Atwater  was  a  pioneer  in  this  country  in  making 
food  investigations,  and  constructed  what  was  called  a  respiration 
calorimeter,  which  was  a  large  box  in  which  an  experimenter  could  re- 
main for  several  days,  all  food  used  could  be  weighed,  and  all  the  prod- 
ucts of  the  digestion  and  respiration  could  be  analyzed.  The  work  done, 
or  mechanical  energy  produced  by  the  food  eaten,  could  also  be  ac- 
curately measured. 

It  has  also  been  ascertained  that  if  food  is  burned  in  a  bomb  calori- 
meter in  the  laboratory,  the  amount  of  heat  evolved  corresponds  very 
closely  to  the  heat  or  energy  produced  by  the  digestion  of  the  food  in  the 
body.  The  analysis  of  a  food  tells  us  the  calories  of  heat  or  energy, 
for  it  is  established  that — 

One  pound  of  protein  gives 1,860  calories. 

One  pound  of  fat  gives 4,220  calories. 

One  pound  of  carbohydrates  gives 1,860  calories. 

A  calorie  is  the  amount  of  heat  that  is  required  to  raise  the  tempera- 
ture of  one  kilogram  of  water  from  0°  to  1°C.  This  explanation  is  neces- 
sary that  the  data  shown  in  the  tables  following  may  be  intelligible. 

There  are  two  general  methods  of  studying  the  amount  of  food  needed 
for  an  individual.  The  first  is  to  ascertain  accurately  how  much  food  of 
each  kind  is  consumed  by  a  family,  a  club  or  an  institution  in  a  given 
time — say  a  month — then  to  find  the  food  value  of  this  total  amount  of 

(5) 


6  A  Dietary  Study. 

food,  and  from  this  data  to  get  the  amount  per  day  per  capita.  In  this 
method  we  consider  the  food  under  ordinary  conditions  of  feeding,  where 
no  attempt  is  made  to  limit  the  diet. 

The  second  method  is  to  have  "feeding  squads"  to  whom  determined 
amounts  of  food  are  given;  here  the  diet  can  be  regulated  and  different 
proportions  of  the  nutrients  given,  and  the  waste  matter,  or  "products 
of  the  metabolism,"  can  be  studied. 

The  former  method,  or  a  study  of  the  food  under  normal  conditions, 
has  been  used  in  the  work  on  Kansas  institutions.  The  chemistry  de- 
partment of  the  University,  at  the  request  of  the  state  auditor's  office, 
made  some  dietetic  studies  of  the  food  used  at  the  State  Penitentiary, 
and  these  results  are  published  in  a  report  of  the  auditor  under  date  of 
March  17,  1916.  At  the  request  of  the  State  Board  of  Administration, 
the  chemistry  department  has  more  recently  made  a  study  of  other  in- 
stitutions under  the  care  of  the  Board. 

Some  of  the  objects  of  this  investigation  were  to  find  out  as  far  as 
possible : 

First:   Whether  the  quantity  of  food  used  is  sufficient  for  the  inmates. 

Second:    Is  the  quality  satisfactory? 

Third:  Are  the  different  nutritives  so  distributed  that  there  is  a  suffi- 
cient proportional  quantity  of  carbohydrates,  fats  and  proteins? 

Fourth:  Is  it  possible  to  substitute  cheaper  foods  for  those  issued  and 
still  keep  up  the  proper  dietary? 

Fifth:  Could  any  other  foods  be  added  to  the  menu  with  advantage 
to  the  inmates? 

Sixth:  Is  there  any  unnecessary  waste  in  preparing,  dispensing  or 
serving  the  food? 

Seventh:  Are  all  the  waste  products  utilized  as  far  as  possible  by 
feeding  to  animals  and  in  similar  ways? 

Eighth:  Can  the  variety  of  food  be  increased  without  additional  ex- 
pense? 

With  these  objects  in  view,  the  steward  has  been  asked  to  furnish  the 
quantity  of  each  kind  of  food  issued  per  month,  and  this  investigation 
has  been  carried  through  for  four  or  six  months,  or  in  some  cases  for  an 
entire  year,  which  would  cover  both  the  summer  and  winter  dietary. 

The  results  given  in  the  following  tables  have  been  compiled  from  the 
steward's  report,  and  following  the  tables  is  a  discussion  of  the  results, 
with  suggestions  as  to  any  possible  improvements  that  might  be  made. 

As  in  most  of  these  institutions  the  steward  issues  the  needed  foods 
daily  to  the  different  kitchens  (at  the  Penitentiary  there  are  four),  an 
accurate  account  is  kept  of  the  daily  population,  or  those  who  use  this 
food,  and  from  this  data,  at  the  end  of  the  month,  we  have  what  the 
inmates  have  lived  on  for  that  month.  In  most  of  these  kitchens  the 
waste  is  fed  to  hogs,  so  that  the  actual  loss  of  food  material  is  small. 
The  fruits,  vegetables,  etc.,  raised  on  the  institution  farm  are  accounted 
for,  and  issued  to  the  inmates  as  if  purchased  at  market  price.  This 
practice,  of  course,  greatly  lowers  the  actual  cost  to  the  state  of  keeping 
the  inmates  of  these  institutions. 


Introductory,  7 

There  are  in  the  state  of  Kansas  the  following  institutions   which 
provide  shelter,  food  and  clothing  for  the  inmates: 
Educational  institutions : 

1.    School  for  Deaf,  Olathe. 
2. .  School  for  Blind,  Kansas  City. 
Charitable  institutions : 

3.  Topeka  State  Hospital. 

4.  Osawatomie  State  Hospital. 

5.  Parsons  State  Hospital  for  Epileptics. 

6.  State  Training  School,  Winfield. 

7.  State  Hospital,  Larned. 

8.  State  Orphans'  Home,  Atchison. 

9.  State  Hospital  for  Tuberculosis,  Norton. 
Correctional  institutions : 

10.  Penitentiary,  Lansing. 

11.  Industrial  Reformatory  for  Young  Men,  Hutchinson. 

12.  Industrial  School  for  Boys,  Topeka. 

13.  Industrial  School  for  Girls,  Beloit. 

14.  Industrial  Farm  for  Women,  Lansing. 

The  reports  made  on  these  institutions  cover  different  periods  of  time, 
beginning  in  1916.  From  the  steward's  report  a  table  is  made,  giving  the 
names  of  food  materials,  quantity;  and,  in  pounds,  the  weight  of  'pro- 
teins, fat,  and  carbohydrates;  and  finally,  the  total  calories  for  that  food. 
The  calories  are  calculated  according  to  a  well-known  method  from  the 
table  of  food  analysis  which  is  published  by  the  United  States  Department 
of  Agriculture,  or  the  Laboratory  Manual  of  Dietetics,  by  Dr.  M.  S.  Rose. 
Figures  in  the  column  labeled  "calories"  show  that  the  most  of  the  energy 
from  the  food  comes  from  bread,  beef,  butterine,  beans,  flour,  lard,  corn 
meal,  milk,  potatoes,  rice  and  syrup.  There  is  a  great  variety  in  the 
food,  as  shown  in  some  cases  by  the  tabulation  of  the  varieties  of  food 
furnished  for  each  month. 

In  the  condensed  reports  of  the  different  institutions  which  follow,  a 
complete  list  of  foods  used  for  a  single  month,  taken  at  random,  is  given, 
and  this  is  followed  by  tables  based  on  the  study  of  the  entire  period. 
As  this  comparison  of  dietaries  was  made  at  different  periods,  partly 
during  the  war,  it  is  not  possible  to  compare  too  critically  the  institu- 
tions the  one  with  the  other,  either  with  reference  to  costs  or  variety  of 
foods  served. 


I. 

KANSAS  STATE  PENITENTIARY. 

(Abstract  of  Report.) 


Lawrence,  Kan.,  March  11,  1918. 
Following  is  an  abstract  from  the  report  on  the  food  and  dietary  fur- 
nished at  the  State  Penitentiary  at  Lansing. 

QUALITY  OF  FOODS. 

The  stores  examined  were  of  good  quality.  A  few  special  samples  of 
foods  were  obtained  for  examination  in  the  laboratory  of  the  State  Uni- 
versity, and  those  showed  that  the  quality  was  good,  with  no  indication 
of  adulteration. 

FOOD  SUPPLIED  FOR  EACH  OF  SIX  MONTHS  OF  1917. 

The  food  is  given  out  daily  from  the  storeroom  to  the  four  kitchens — 
main,  female  ward,  hospital,  and  insane — on  requisitions.  From  these 
figures  of  the  storekeeper  we  have  obtained  the  amount  issued  to  each 
kitchen  for  the  six  months  beginning  July  1,  1917.  The  total  amount  of 
each  food  for  each  of  the  above  months,  with  the  number  of  pounds  of 
protein,  fat  and  carbohydrates,  and  the  calories  or  units  of  energy  of 
each,  and  the  sum  for  the  month,  are  given  in  the  accompanying  tables. 
The  detailed  report  for  the  single  month  of  September  is  shown  herewith. 

(8) 


Kansas  State  Penitentiary. 


KANSAS  STATE  PENITENTIARY. 
TABLE  A.— Dietary  of  all  four  kitchens  for  September,  1918. 


Articles  of  Food. 

Pounds. 

Protein, 
pounds. 

pounds. 

Carbo- 
hydrates, 
pounds. 

Calories. 

Apples  green 

8,232.00 

150.00 

150.00 

1,100.00 

1,100.00 

560.00 

2,935.00 

19,484.00 

1,550.00 

1,320.00 

525.00 

4,650.00 

197.00 

714.00 

78.00 

347.50 

198.30 

5,183.00 

316.00 

228.00 

17,862.00 

1,800.00 

600.00 

630.00 

2,400.00 

3,425.00 

15.00 

22.50 

900.00 

56.25 

50.00 

3,125.00 

5,339.00 

22,880.00 

1,875.00 

200.00 

290.00 

250.00 

28.50 

500.00 

24.00 

1,003.00 

300.00 

2,200.00 

2,200.00 

2,706.00 

1,500.00 

30,026.00 

200.00 

24.69 
2.40 

24.69 
3.30 

889.05 
99.15 
67.50 
716.10 
655.60 
369.04 
202.51 

1,761,648 

197.700 

Baking  powder                   

122,400 

240.90 

247.50 

103.36 

61.63 

2,825.18 

20.15 

15.84 

4.72 

65.10 

49.64 

8.56 

4.29 

33.90 

19.43 

36.28 

48.66 

27.13 

2,000.54 

14.30 

19.80 

8.40 

8.80 

3,273.31 

1.55 

1,095.60 

1.05 

9.30 

66.38 

.      2.85 

1.17 

42.28 

18.04 

10.36 

50.56 

21.20 

178.62 

1,800.00 

11.40 

45.36 

816.00 

10.27 

.36 

.02 

9.00 

.16 

.15 

1,712.50 

4,214.83 

22.88 

11.25 

1,842,500 

Beans  white              

1,720,400 

888,160 

Beans,  green         

516,560 

Beef  fresh 

19,094,320 

Beets       

119.35 

258,850 

Butterine 

4,501,200 

Carrots  

38.85 

223.20 

4.72 

54.97 

63.18 

343.60 

144.95 

134.75 

83,475 

Cabbage 

560,790 

Cheese 

384,150 

Corn  green                         .         

127,092 

127,218 

Crackers  cream                ...       

676,282 

371,812 

Cucumbers                   

352,444 

Ducks 

293,880 

Ekks              

135,660 

f£..... ;:::::::::::::::::. .:::.:. 

13,378.63 

28,632,786 

Lard                 

7,347,600 

55.20 

101.43 

673.20 

47.95 

1.32 

.15 

42.30 

.16 

.25 

234.37 

315.00 

411.84 

26.25 

3.60 

2.61 

8.05 

.22 

4.00 

5.68 

182.54 

452.40 

425.25 

1,020.00 

339.07 

.58 

2.43 

562.50 

10.12 

1.35 

967,800 

Meal,  oat     

1,140,310 

Milk 

6,405,600 

Onions 

681,575 

Oysters 

5,025 

Peaches 

4,792 

Peaches,  dried 

1,134,000 

Pears 

19,550 

Pickles 

3,500 

Pork,  fresh 

7,671,875 

Pork  salt 

18,339,465 

Potatoes,  Irish 

3,363.36 
410.62 
124.40 

11.60 
239.75 

16.07 
395.00 

6,955,520 

Potatoes,  sweet 

838,125 

232,300 

Radishes 

.29 

10.50 

.59 

1.50 

2.90 

197.59 

26,970 

Raisins 

492,450 

Raspberries 

32,775 

Rice 

795,500 

Sardines         ...                       

22,176 

Sausage  bologna 

1,137  402 

285.00 
5,200.00 
24.20 
165.06 
67.50 
1,171.01 
42.00 

517,200 

9,432,800 

Sausage,  pork          

286.00 
757.68 

10.50 
270.23 

23.40 

968.00 

598.02 

3.00 

120.10 

.80 

4,514,400 

4,018,410 

Squash 

154,500 

Tomatoes 

3,092,678 

Yeast 

122,000 

Totals 

167,225-05 

9.303.83 

15.409.03 

31,834.42 

138,755.625 

10 


A  Dietary  Study. 


In  addition  to  the  report  on  all  four  kitchens,  and  as  a  check  for  com- 
parison of  the  amounts  of  food  used,  a  study  is  also  made  of  the  dietary 
for  the  months  of  October  and  December  for  the  main  kitchen  and  the 
female  ward.     The  details  of  these  are  not  given  in  the  abstract. 


K\N5AS  STATE  PENITENTIARY. 
TABLE  B.— Summary  for  all  four  kitchens  and  of  main  kitchen  and  female  ward. 


-Per  capita  use  of  food. 


Dietaries. 

Weight 

of 
foods, 
pounds. 

Protein. 

Fat. 

Carbohydrates. 

Calories. 

Pounds. 

Grams. 

Pounds. 

Grams. 

Pounds. 

Grams. 

1917. 
July 

5.57 

7.55 
6.92 
5.65 
5.58 
4.88 

0.36 
.35 
.38 
.28 
.35 
.30 

163.29 
158.76 
174.36 
127.00 
158.22 
136.54 

0.56 
.51 
.63 
.38 
.57 
.39 

254.01 
231.33 
285.76 
173.. 36 
258.55 
176.90 

1.45 
1.60 
1.39 
1.59 
1.46 
1.42 

657.72 
725.76 
630.50 
721.22 
662.25 
644.11 

5,441 

August   .  . 

5  821 

September 

October  . . 

5,748 
5  332 

November 

5,734 

December 

4,799 

Average 

5.93 

0.32 

147.60 

0.49 

223.18 

1.48 

673,59 

5,389 

COMPARISON   or   SINGLE    KITCHENS. 


Main  kitchen,  October .... 
Female  kitchen,  October .  . 
Main  kitchen,  December.  . 
Female  kitchen,  December. 


5.63 

0.33 

152.40 

0.44 

199.58 

1.60 

725.75 

4.93 

.25 

113.40 

.27 

122.47 

1.38 

625.96 

4.77 

.27 

124.47 

.38 

172.35 

1.39 

630.50 

3.72 

.21 

96.25 

.23 

104.32 

1.00 

453.60 

5,383 
4,049 
4,557 
3,441 


KANSAS  STATE  PENITENTIARY. 
TABLE  C. — Comparison  of  per  capita  use  of  some  of  the  important  staples  at  Lansing,  for  all  four  kitchens  for 

each  of  six  months,  1917. 


Staples 

July, 

August, 

September, 

October, 

November, 

December, 

ounces. 

ounces. 

ounces. 

ounces. 

ounces. 

ounces. 

Flour 

10.56 

12.96 

11.84 

12.64 

10.24 

12.80 

Hominy  and  corn  meal.  . . 

.50 

.32 

.32 

1.44 

1.12 

1.00 

Potatoes,  Irish 

10.72 

13.44 

15.04 

11.84 

14.88 

15.04 

Potatoes,  sweet 

1.12 
1.76 

8.48 
1.44 

9.12 
1.60 

4.12 

Beans  and  peas,  dry 

1.92 

1.44 

1.44 

Sugar 

2.56 

2.40 

1.60 

4.80 

1.76 

1.76 

Sirup 

3.84 
8.48 

4.64 
8.80 

2.08 
9.28 

4.12 
11.52 

3.04 

Beef 

12.80 

7.68 

Pork,  fresh  and  salt 

5.60 

3.84 

5.60 

1.76 

4.48 

1.44 

Lard 

.80 

1.00- 

1.12 

1.28 

1.00 

1.12 

Sausage,  four  varieties 

4.64 

3.84 

3.84 

4.48 

4.48 

2,88 

Butterine 

.50 

.64 

.80 

.64 

1.00 

1,00 

Milk 

16.48 

15.52 

13.44 

10.24 

8.00 

7.68 

DISCUSSION   OF  RESULTS. 

Considering  the  "fuel  value"  or  calories  furnished  by  the  food  sup- 
plied, and  the  amount  of  protein  per  capita  for  each  of  the  six  months, 
it  will  be  noted  that  the  range  of  calories  for  the  six  months  considered 
is  from  4,799  to  5,821,  with  an  average  of  5,389.  The  female  kitchen  for 
October  and  December  is  4,049  and  3,441.  It  is  estimated  that  women 
need  one-fifth  less  food  than  men.  A  recent  authority,  Doctor  Davis,  in 
Food  in  Health  and  Disease,  quotes  the  following  dietary  standards  for 
the  United  States : 

Grams  protein.      Calories. 

Women   with   light  muscular  work 90  2,400 

Women    with   moderate   muscular   work 100  2,700 

Men    without    muscular    work    100  2,700 

Men  with  light  muscular  work 112  3,000 

Men  with  moderate  muscular   work    125  3,500 

Men   with   hard    muscular   work 150  4,500 


Kansas  State  Penitentiary.  11 

Doctor  Langworthy,  of  the  United  States  Department  of  Agriculture, 
gives  similar  figures  for  men  only,  which  range  from  2,450  without  mus- 
cular work  to  5,500  for  very  hard  muscular  work. 

Considering  the  number  of  inmates  fed  one  day  during  the  six  months 
at  the  Lansing  Penitentiary,  which  is  144,975:  31,104,  or  21.5  per  cent, 
are  in  the  female,  insane  and  hospital  kitchens  and  would  not  need  the 
greatest  quantity  of  food;  of  the  remaining  78.5  per  cent,  many  are  en- 
gaged in  light  muscular  work.  It  would  seem  then  that  an  average  of  not 
over  3,500  calories  ought  to  be  sufficient  for  the  inmates  of  this  institu- 
tion. The  figures  show  that  there  is  an  excess  of  1,800  calories  per  day 
per  capita. 

In  regard  to  the  amount  of  protein  used,  the  proportion  between  that 
and  the  other  food  is  fairly  well  maintained.  There  is,  however,  too 
much  protein  used,  the  average  for  the  six  months  being  153  grams  per 
day  per  capita,  while  120  grams  should  be  sufficient.  There  should  be 
a  decrease  in  the  total  food  issued  which  would  bring  the  protein  down 
to  nearer  the  required  amount,  and  the  proportion  of  carbohydrates 
(bread,  sugar,  syrup)  and  of  fats  (pork  and  sausages)  might  be  still 
further  reduced. 

DIETARY  TABLE,   PER   CAPITA. 

Attention  is  further  called  to  the  nutritive  ratio  of  dietaries  per  capita 
for  each  month,  as  shown  in  table  B.  This  shows  the  actual  weight  of 
food  used  by  each  inmate,  and  of  what  it  consisted.  There  is  an  appreci- 
able decrease  in  the  weight  of  the  food  for  December,  which  is  also  shown 
by  the  calories  consumed.  The  number  of  grams  of  protein  consumed  for 
each  month  is  also  given,  which  can  be  compared  with  the  120  grams 
assumed  to  be  sufficient.  There  is  a  notable  diminution  in  the  number 
of  calories  and  in  the  weight  of  the  food  for  December.  This  may  be 
due  partly  to  the  use  of  less  sugar. 

PER  CAPITA  USE  OF  STAPLE  FOODS. 

Referring  to  table  C,  a  comparison  is  made  of  the  staple  foods  used 
for  each  month,  both  in  decimals  of  a  pound,  and,  for  convenience,  in 
ounces. 

Flour  ranges  from  10.24  to  12.96  ounces.  This  amount  would  give  a 
little  more  than  a  pound  of  bread  for  each  person.  Corn  meal  and  corn 
products  should  replace  to  a  greater  extent  the  wheat  products. 

Sweet  potatoes  evidently  when  served  do  not  take  the  place  of  Irish 
potatoes,  as  might  be  the  case,  but  are  served  in  addition  to  the  Irish 
potatoes. 

In  regard  to  sugar  and  sirup,  the  United  States,  before  the  war,  used 
of  sugar  3.95  ounces  per  capita. 

Per  capita. 

Hoover's   estimate   of   amount   necessary    1.58  ounces 

France  uses 57   ounces. 

England    uses    1.14  ounces. 

Italy    uses    39  ounces. 

The  figures  shown  above  for  the  Kansas  Penitentiary  show  the  use  of 
2.5  ounces,  with  an  addition  of  3.5  ounces  in  the  sirup,  thus  making  6 
ounces  all  together. 

The  amount  of  beef  varies  from  8.48  ounces  to  12.8  ounces,  but  to  this, 
for  animal  food,  must  be  added  the  pork,  lard  and  sausages. 


Aug. 

Sept. 

Oct. 

Nov. 

Dec. 

26.07 

23.75 

29.79 

22.50 

32.62 

13.46 

13.76 

13.51 

13.34 

12.75 

2.12 

2.78 

1.97 

2.93 

3.54 

14.07 

8.53 

14.78 

11.63 

11.70 

7.30 

7.17 

9.73 

8.32 

11.17 

5.74 

4.99 

4.00 

6.79 

3.68 

31.28 

39.77 

26.59 

33.64 

24.41 

12  A  Dietary  Study. 

The  amount  of  butterine  is  not  excessive,  and  increases  during  the  cold 
weather,  as  would  be  expected. 

CLASSIFICATION   OF  GROUPS   OF  FOODS. 
All  four  kitchens,  each  of  six  months — per  cent  of  calories  of  total  calories. 
Clasaes.  July. 

Breadstuffs 26.53 

Vegetables    9.60 

Fruits 3.39 

Sugar,  sirup 13  .  60 

Lard,   butterine    3.50 

Milk,   cheese,   eggs    6.91 

Meats,  fowls,  fish 36.50 

This  shows  a  great  variation  in  the  different  months ;  and  although  one 
class  may  take  the  place  of  another  to  a  certain  extent,  yet  it  would  seem 
that  it  should  be  more  uniform. 

FOOD   COST,   PER   CAPITA. 

A  practical  study  of  the  per  capita  cost  of  food  for  inmates  of  peni- 
tentiaries in  some  of  the  surrounding  states  is  given  below.  More  de- 
tailed information  will  be  furnished  on  this  point  when  comparison  with 
the  different  institutions  is  completed. 

Cost  per  day 
per  capita. 

Indiana  penitentiary  (Michigan  City) 14 . 9   cents. 

Kentucky  penitentiary    17.3    cents. 

Minnesota   penitentiary    (Stillwater)     23 . 0   cents. 

Missouri  penitentiary 24.0   cents. 

Illinois  penitentiary    ( Joliet)    37.0   cents. 

Kansas  penitentiary   (Lansing) 39.5   cents. 

SUMMARY.  ^ 

1.  Since  the  amount  of  food  supplied  appears  to  be  higher  than  neces- 
sary, it  should  be  decreased  as  much  as  can  be  done  without  injury  to  the 
health  and  well-being  of  the  inmates. 

2.  The  use  of  20  per  cent  of  corn  meal,  rye  flour  or  some  other  sub- 
stitute in  the  bread  is  to  be  commended.  Bolted  corn  meal,  rather  than  a 
corn  fiour  that  has  been  degerminated  and  thus  deprived  of  most  of  its 
fat,  is  recommended  for  use. 

3.  The  amount  of  sugar  products  and  sirup  is  still  too  high.  Although 
starch  is  a  satisfactory  food  when  muscular  exertion  is  required,  rt  a 
part  of  it  is  replaced  by  sugar  there  is  less  tendency  to  fatigue.  As 
much  as  five  ounces  per  day  can  be  utilized  in  the  body,  but  so  much  is 
not  necessary. 

4.  If  more  lard  is  used  than  is  furnished  by  the  farm,  a  substitute  con- 
sisting largely  of  vegetable  oils  and  fats,  a  number  of  which  are  on  the 
market,  may  be  substituted  for  a  part  of  the  lard  purchased,  at  a  con- 
siderable saving. 

5.  As  the  protein  foods,  such  as  meats,  sausage,  etc.,  are  usually  the 
most  expensive  part  of  the  diet,  these  should  be  diminished,  in  the  interest 
of  economy. 

6.  Fish  is  more  rapidly  and  just  as  completely  digested  as  meat.  It 
is  extensively  used  as  a  part  of  the  dietary  of  most  public  institutions.  It 
will  add  to  the  variety  of  the  diet,  and  if  bids  were  asked  for  a  definite 
delivery  per  week,  its  use  might  diminish  the  cost  of  protein  foods. 


Kansas  State  Penitentiary.  13 

7.  The  use  of  larger  quantities  of  vegetables  and  fruits,  especially  in 
season,  will  add  greatly  to  the  bulk  of  the  food,  and  allow  a  decrease  of 
the  heavier  staple  foods.  If  the  vegetables  and  fruits  can  be  raised  on  the 
farm,  so  much  the  better. 

8.  At  the  beginning  of  the  season  complete  arrangements  should  be 
made  by  the  purchase  of  a  suitable  canning  apparatus  to  can  large 
quantities  of  fruit  and  vegetables,  especially  corn,  peas,  tomatoes,  sweet 
potatoes,  pumpkins,  peaches  and  pears.  Much  of  this  material  can  be 
raised  on  the  farm. 

9.  In  some  states,  especially  in  Illinois,  a  system  of  dietaries  is  care- 
fully worked  out  for  the  institutions,  and  those  in  charge  of  the  kitchen 
are  required  to  follow  them  in  the  serving  of  meals  to  the  inmates. 

10.  As  the  matter  of  per  capita  cost  of  the  food  is  involved  in  all  the 
statements  made  above,  no  definite  suggestions  on  this  point  are  necessary. 


Lawrence,  Kan  ,  April  20,  1918. 
In  order  to  arrive  more  accurately  at  the  amount  of  food  used  in  a 
given  time,  a  careful  account  of  food  used  in  the  main  kitchen  daily, 
from  March  11  to  April  9,  1918,  inclusive,  was  made,  and  from  the  total 
amount  of  protein,  fat,  carbohydrates  and  calories  for  these  periods  the 
following  per  capita  use  of  foods  was  determined: 

PER  CAPITA  USE   OF  FOODS  FOR  FIVE-DAY  PERIODS. 

Date.  Protein.  Fat.          Carbohydrates.     Calories. 

March   11-15     140.61  199.98  734.80  5,409 

March    16-20     113.40  226.80  548.80  4,587 

March   21-25     131.54  185.97  '557.92  4,572 

March   26-30     154.22  172.36  604.80  5,698 

March  31   to  April  4 127.00  204.00  585.00  4,416 

April  5-9     108  .  86  158  .  76  508  .  00  4,000 

Average    129.32  191.31  589.88  4,780 


Lawrence,  Kan.,  October  10,  1018. 

Referring  to  a  report  on  the  dietary  of  the  State  Penitentiary  at 
Lansing,  under  date  of  March  11,  1918,  and  to  a  supplementary  report 
under  date  of  April  20,  1918,  on  the  food  actually  used  for  five-day 
periods  from  March  11  to  April  9,  the  officers  of  the  institution  kindly 
gave  the  data  for  making  another  special  test  of  the  food  for  seven-day 
periods  from  May  12  to  June  10.  It  was  thought  that  a  seven-day  period 
would  show  more  fairly  the  quantity  of  food  actually  used,  as  the  coal 
miners  especially  cleaned  up  a  certain  amount  of  coal*  in  a  weekly  run, 
and  did  more  work  at  the  beginning  of  the  week  than  at  the  end.  This 
test  was  made  especially  to  ascertain  whether  any  improvement  had  been 
made  in  the  direction  of  decreasing  the  actual  amount  of  food  used,  as 
well  as  in  diminishing  the  total  protein  and  carbohydrates  in  the  diet. 

The  tests  were  made  on  the  main  kitchen  and  women's  kitchen 
separately.  As  the  number  fed  from  the  main  kitchen  is  so  much  larger 
than  that  from  the  other  kitchens,  it  is  better  to  derive  most  of  the  con- 
clusions from  an  inspection  of  these  figures. 


14 


A  Dietary  Study. 


KANSAS  STATE  PENITENTIARY. 
Main  kitchen,  summary  of  seven-day  periods,  per  capita  use  of  food. 


Period. 

Attendance. 

Amount, 
pounds. 

Protein, 
grams. 

Fat, 
grams. 

Carbo- 
hydrates, 
grams. 

Calories. 

May  12  to  19 

3,657 
3,790 
3,701 

4.30 
4.32 
3.88 

167 
167 
145 

267 
244 
244 

562 
585 
467 

5,326 

5  287 

May  19  to  26 

May  26  to  June  2 

4,872 

Average 

3,716 

4.16 

159 

251 

538 

5,161 

CONCLUSIONS. 

A  consideration  of  the  results  shown  in  the  table  for  the  three  seven- 
day  periods  shows  that  the  protein,  fat  and  carbohydrates  furnished  are 
all  very  high,  even  for  the  average  of  the  men  fed  from  this  kitchen. 
The  protein  is  167,  167,  145  grams  per  day  per  capita,  while  125  grams 
would  certainly  be  a  great  excess.  Doctor  Langworthy,  an  authority  on 
nutrition,  in  the  United  States  Year  Book,  Department  of  Agriculture, 
1907,  gives  the  figures  as  for  average  of  162  studies  of  "Men  at  moderate 
muscular  work,"  farmers,  artizans,  laborers,  etc.,  protein  100  grams, 
with  a  total  energy  of  the  diet  at  3,685  calories.  Men  at  hard  muscular 
work  and  athletes  would  of  course  require  more  food,  but  the  average  of 
such  men  belong  to  a  different  class  from  those  in  the  penitentiary. 

As  the  fats  and  carbohydrates  are  also  high,  the  average  of  the 
calories  for  the  three  periods  studied  is  5,161,  which  is  at  least  1,500 
more  than  necessary. 

A  chart  was  ma-de  representing  a  comparison,  expressed  in  ounces,  of 
the  daily  per  capita  consumption  of  food  at  Lansing  State  Penitentiary 
from  May  12  to  June  1,  1918,  and  the  daily  per  capita  consumption  of 
food  in  national  training  camps.  The  data,  which  were  for  young  and 
vigorous  men  in  hard  physical  training,  using  the  training-camp  messes, 
was  obtained  from  the  article  "Diet  of  the  United  States  Army  Soldier  in 
the  Training  Camp,"  by  Dr.  John  R.  Murlin,  in  the  Journal  of  American 
Medical  Association  for  September  21,  1918. 

The  Lansing  diet  yielded  5,161  calories  per  day  for  the  three  weeks 
referred  to.  The  training-camp  diet  messes  yielded  3,963  calories  per  day. 
In  regard  to  fresh  beef,  the  Lansing  dietary  for  each  week  is  nearly 
50  per  cent  higher  than  that  of  the  army  messes.  Fresh  beef  and  pork 
taken  together  show  that  more  is  used  at  the  Penitentiary  than  at  the 
camps.  In  the  case  of  bacon  and  sausage  there  is  three  times  as  much 
used  as  at  the  Penitentiary,  and  the  fats  from  lard  and  compound  are 
two  and  one-half  times  as  much. 

Butter  and  butterine  is  about  the  same  in  both  tables.  Twice  as  much 
syrup  is  used  at  the  Penitentiary,  but  much  less  sugar,  as  the  sugar 
ration  had  been  cut  down. 

More  than  twice  the  weight  of  dried  beans  was  used  at  the  Peniten- 
tiary, and  more  cereals  for  each  of  the  three  weeks  considered. 

Except  in  the  case  of  the  first  week,  more  potatoes  were  consumed  in 
the  army  messes  than  at  the  Penitentiary. 


Kansas  State  Penitentiary,  15 

More  flour  and  more  milk  are  consumed  at  the  Penitentiary  than  in 
the  camps.  Dried  and  other  fruits  and  vegetables  do  not  show  any- 
startling  difference  in  amounts. 

The  figures  all  indicate  that  without  any  loss  in  efficiency  of  the  men 
at  work,  and  in  the  interests  of  health  and  economy,  the  total  amount  of 
food  can  be  appreciably  cut  down.  While  we  are  saving  food  in  every 
possible  way  to  send  to  our  allies  across  the  water,  it  is  a  suitable  time 
to  begin  reforms  in  those  institutions  over  which  the  state  has  control. 


II. 

STATE  INDUSTRIAL  REFORMATORY,  HUTCHINSON. 

(Abstract  of  Report.) 


Lawrence,  Kan.,  May  16,  1918. 

The  dietary  of  the  institution  was  furnished  me  by  Mr.  J.  N.  Herr, 
superintendent,  from  the  quantity  of  food  consumed  for  the  months  of 
July,  1917,  to  February,  1918,  inclusive.  In  each  case,  from  the  total 
amount  of  food  used  and  a  knowledge  of  each  food  product,  the  pounds 
of  protein,  fats  and  carbohydrates  were  computed.  From  this  it  was 
easy  to  obtain  the  total  calories  or  food  value  of  each  foodstuff  used. 

Table  A  shows  the  amount  of  staples  used  per  day  per  capita  in  each 
of  the  eight  months. 

Table  B,  subdivision  1,  shows  the  amount  of  food  per  capita  per  day. 

Table  B,  subdivision  2,  is  a  comparison  of  dietaries  for  each  of  the 
eight  months. 

Table  C  is  a  classification  of  groups  of  foods  for  each  of  the  eight 
months  studied. 

Table  D  shows  the  number  of  pounds  and  per  capita  of  three  food 
nutrients  obtained  from  each  of  a  selected  list  of  foods. 

As  illustrative  of  table  A,  the  dietary  for  October  is  given.  Fifty 
different  food  products  were  utilized  in  the  dietary  for  the  period  studied. 

(16) 


state  Industrial  Reformatory, 


17 


KANSAS  STATE  INDUSTRIAL  REFORMATORY. 

Dietary  for  Oclober,  1917. 


Articles  of  Food. 

Pounds. 

Protein, 
pounds. 

pounds. 

Carbo- 
hydrates, 
pounds. 

Calories. 

Apples             

13,680.00 

40.00 

900.00 

1,770.00 

1,200.00 

5,175.00 

30.00 

1,(60.00 

480.00 

6.00 

1,800.00 

40.00 

75.00 

15.00 

20.00 

4.50 

6,000.00 

62.00 

778.00 

360.00 

100.00 

200.00 

7,S12.00 

1,425.00 

15.00 

6.25 

15.00 

120.00 

1,500.00 

2,750.00 

2,180.00 

900.00 

753.00 

2,100.00 

900.00 

6,160.00 

3,300.00 

30.00 

41.04 

41.04 

1,477.44 

12.00 

536.40 

112.13 

781.20 

2,927,520 

Baking  powder 

21,760 

Bejns,  navy    

202.50 

37.17 

2t2.80 

750.37 

.30 

25.48 

5.76 

.09 

25.20 

11.52 

.67 

.42 

1.96 

.74 

672.00 

5.14 

16.20 

5.31 

15.60 

869.40 

25.50 

1.96 

398.40 

.01 

3.60 

14.36 

.15 

.18 

1.82 

.13 

60.00 

.37 

778.00 

3.24 

l.SO 

14.60 

292.48 

4.27 

.36 

1,407,600 

Beans  tcreen 

311,520 

2,010,000 

Beef  fresh 

5  071,500 

Butter 

104,640 

Beets                               

150.92 

131,320 

1,636,800 

Catsup                                      . .       ... 

.74 

86.40 

.12 

5.55 

2.85 

14.62 

3.42 

4.494.00 

48.98 

1,590 

Cabbage 

217,080 

Cheese 

79,760 

Carrots 

11,925 

Corn                        ...                 

6,667 

Crackers 

37,500 

Egg  compound            

8,469 

Flour 

9,618,000 

Hominy                       

99,696 

Lard 

3,175,796 

Macaroni        

48.24 

9.20 

33.40 

241.29 

19.95 

1.32 

.04 

.54 

29.52 

27.00 

38.50 

10.90 

7.20 

137.04 

266.76 

75.40 

132.40 

365.60 

126.82 

.58 

.67 

1.47 

74.40 

220.50 

602.25 

56.68 

711.00 

584,640 

161,300 

Mefil,  oat     

360,600 

Milk 

2,295,(68 

Onitns     .    .       

283,575 

Oysters 

5,025 

Peaches   

1,331 

Peas 

.03 
1.20 
1.50 
16.50 
2.18 
2.70 
148.34 

3,765 

Peas,  split,  dry    

193,440 

456,000 

1,229,250 

130,800 

Rice 

1,431,900 

Bologna 

853,902 

Sugar 

2,100.00 

567.00 

240.24 

188.10 

6.30 

3,809,400 

Sorghum 

21.60 

55.44 

29.70 

3.50 

1,067,400 

Tomatoes. 

24.64 

3.30 

.12 

634,480 

Turnips 

Yeast 

409,260 
18,300 

Totals 

64,161  75 

2,757.54 

2,74()..39 

13,462.94 

40,810,479 

KANSAS  STATE  INDUSTRL\L  REFORMATORY. 
TABLE  A.— Amount  of  staples  used  per  day  per  capita  for  each  of  the  eight  months. 


Staples. 


Flour... 

Macaroni 

Hominy  and  corn  meal. . . 

Potatoes,  Irish 

Potatoes,  sweet 

Beans  and  peas,  dry 

Sugar _: 

Sirup  (in  terms  of  sugar) . 

Beef,  fresh  and  dried 

Pork,  fresh  and  salt 

Lard  and  shortening 

Bologna  sausage 

Butterine  and  butter 

Milk 


July 
and 
Aug., 
1917, 
average. 


Oa. 
14.72 
.20 
.016 

6.56 


3.04 
2.40 

.22 
1.71 
6.56 
1.04 

M 


Sept., 
1917. 


Oct., 
1917. 


Oz. 

19.36 
.20 
.77 
6.56 
2.24 
2.88 
2.24 


4.64 
.20 

1.13 
.88 
.73 

9  ^'', 


Oz. 

8.32 

.50 

.22 

2.08 

4.16 

3.04 

2.88 

.83 

7.20 


1.12 


Nov., 

Dec, 

Jan., 

Feb., 

1917. 

1917. 

1918. 

1918. 

Oz. 

Oz. 

Oz. 

Oz. 

17.60 

14.72 

14.72 

14.43 

.21 

.13 

.15 

.96 

1.62 

.60 

.32 

7.52 

12.80 

14.50 

4.48 

29.60 

2.40 

2.72 

2.72 

2.03 

2.24 

1.92 

1.92 

1.92 

.83 

.83 

2.56 

2.03 

6.88 

5.76 

6.53 

5.76 

1.17 

1.22 

1.02 

1.18 

1.17 

1.12 

.60 

,64 

.88 

1.12 

.72 

.88 

.18 

77 

V)  ')■■ 

10. "^2 

n  ' 

11  R6 

Average. 


Oz. 

14.83 

.77 

.69 

7.73 

12.00 

2.69 

2.21 

1.22 

5.49 

1.89 

.87 

.89 

.62 

10.19 


2 — Dietary — 575 


18 


A  Dietary  Study. 


DISCUSSION  OF  RESULTS. 

It  is  noted  with  satisfaction  that  an  average  of  10.19  ounces  of  milk 
per  day  per  capita  is  used.  This  is  such  a  perfect  food,  to  use  in  correct- 
ing deficiencies  in  diet,  that  the  amount  should  be  increased  as  much  as 
possible.  When  produced  on  the  farm,  even  when  some  of  the  fodder 
must  be  bought,  its  use  tends  to  notably  decrease  the  cost  of  living  per 
capita.  Dr.  E.  V.  McCollum,  the  most  recent  authority  on  dietetics,  ad- 
vises the  daily  use  of  24  ounces  of  milk  as  a  minimum. 

In  considering  table  A  the  first  thing  noted  is  the  irregularity  of 
amounts  of  some  of  the  supplies  furnished.  This  is  more  probably  due  to 
inaccuracies  of  bookkeeping  than  to  a  real  change  in  the  amount  of  food 
furnished.  If  a  supply  for  several  v/eeks  is  issued  to  the  kitchen  at  one 
time,  a  part  of  the  amount  is  liable  to  be  carried  over  from  one  month 
to  the  next,  thus  affecting  the  apparent  food  supplied  to  the  inmates. 
As  an  illustration,  19.36  ounces  of  flour  per  day  per  capita  is  supplied  in 
September  and  only  8.32  in  October.  It  is  evident  from  the  average  of 
the  other  months  that  about  14,5  ounces  is  used  per  day,  but  at  least  25 
per  cent  of  the  wheat  flour  should  be  replaced  by  corn  or  some  other 
cereal. 

There  is  great  irregularity  in  the  Irish-potato  supply.  This  may  be 
due  to  local  causes,  or  to  the  accounting,  as  noted  above.  At  any  rate, 
with  the  present  price  of  potatoes,  their  use  should  be  pressed  to  the 
limit,  and  continued  until  new  potatoes  are  fairly  abundant.  If  the 
potatoes  are  kept  in  a  dark,  cool  place  and  the  sprouts  thoroughly  re- 
moved as  often  as  they  appear,  the  quality  of  the  potato  will  not  be  seri- 
ously impaired. 

In  the  case  of  sugar  there  is  a  slight  decrease  in  the  amount  used  in 
the  later  months,  but  a  notable  increase  in  the  sirup,  so  that  the  sum  of 
both,  which  is  2.62  ounces  in  July  and  August,  increases  to  4  ounces  in 
February.  This  total  saccharine  material  is  probably  more  than  abso- 
lutely needed. 

The  summary  shows  the  amount  of  beef  to  be  low  in  July  and  August, 
as  should  be  the  case  in  warm  weather.  This,  however,  seems  to  be 
more  than  replaced  by  pork. 

The  butter  and  butterine  used  is  not  excessive.  (This  is  hereafter 
referred  to.) 

KANSAS  STATE  INDUSTRIAL  REFORMATORY. 


TABLE  B  (1).— Amount  of  food  per  capita  per  day. 

Month. 

Population. 

Weight 
of  food, 
pounds. 

Protein, 
grams. 

Fat, 
grams. 

Carbo- 
hydrates, 
grams. 

Calories. 

1917. 
July  and  August 

23,684 
10,890 
11,408 
10,8.30 
10,850 

10,819 
9,968 

3.24 
4.61 
5.62 
5.41 
3.82 

4.77 
4.00 

86.18 
131.54 
108.86 
140.61 
123.47 

145.15 
122.47 

81.64 
104.32 
108.86 
131.54 
127.00 

95.25 
113.40 

553.39 
680.40 
535.24 
802.87 
598.75 

666.79 
639.47 

3,413 

4,249 

October       

3,577 

4,966 

December   

4,084 

1918. 

3,705 

February                 

4,235 

Average 

12.635 

4.49 

122.61 

108:86 

639.46 

4,032 

state  Industrial  Reformatory. 


19 


KANSAS  STATE  INDUSTRIAL  REFORMATORY. 
TABLE  B  (2). — Comparison  of  dietaries  for  each  of  eight  months. 


Month. 


July  and  August 

September 

October 

November 

December 

January 

February 

Average 


Grams  of 

protein 

per  capita. 


86.18 
131.54 
108.86 
140.61 
123.47 
145.15 
122.47 


122.61 


T9tal 
weight. 


76,774.06 
50,290.50 
64,161.75 
58,614.75 
41,505.75 
51,625.00 
39,883.25 


54,693.58 


Weight 

'of 
protein. 


4,503.13 
3,237.20 
2,747.54 
3,380.38 
2,935.00 
3,568.40 
2,628.75 


3,287.20 


Weight 
of  fat. 


4,419.69 
2,567.56 
2,749.39 
3,200.79 
3,113.49 
2,299.37 
2,516.90 


2,981.02 


Weight  of 

carbo- 
hydrates. 


28,894.26 
16,418.91 
13,462.94 
19,177.93 
14,362.83 
15,901.70 
14,133.92 


17,478.91 


Total 
calories. 


80,836,619 
46,273,3^4 
40,810,479 
53,780,518 
44,314,393 
40,966,170 
42,227,960 


49,888,503 


In  considering  a  comparison  of  the  dietaries  for  each  of  eight  different 
months,  as  in  table  B  (1  and  2),  there  is  considerable  variation  in  the 
per  capita  calories  or  heat  units  used,  but  the  ratio  between  the  sum  of 
the  fats  and  the  carbohydrates  together,  and  the  protein,  is  fairly  con- 
stant; that  is,  from  1:6  to  1:7.  For  some  reason  the  protein  used  in 
July  and  August  was  low,  which  would  indicate  a  vegetable  diet.  It  has 
been  previously  noted  that  the  beef  was  low  during  these  two  months 
and  the  pork  high. 

The  protein  used  varies  considerably  in  the  different  months,  but  the 
average  (122,47)  is  quite  satisfactory,  especially  when  we  consider  the 
age  of  the  inmates  and  their  necessity  for  abundant  food. 

The  calories  (average,  4,032)  is  probably  somewhat  higher  than  neces- 
sary, as  3,500  would  seem  to  be  enough  for  good  bodily  health.  If  the 
sugar  and  sirup  are  diminished  in  quantity  this  will  tend  to  reduce 
the  amount  of  calories,  and  there  will  still  be  a  sufficient  quantity  of 
nutritional  foodstuffs. 

In  regard  to  the  proportion  of  fat  compared  to  carbohydrates,  although 
no  very  definite  statements  are  made,  the  standards  noted  below  are 
recommended  by  different  authorities  for  men  with  moderate  muscular 
work.  Experience  has  shown  that  to  a  certain  extent  carbohydrates  may 
replace  fats,  but  bodily  health  and  vigor  cannot  be  sustained  without 
^considerable  fat.  The  proportions  at  the  Hutchinson  Reformatory  are 
quite  satisfactory: 

ALLOWANCE  OF  FOODSTUFFS  FOR  A  MAN  AT  MODERATE  MUSCULAR  WORK. 

Voit.  Playfair.  Gautier. 

Protein 118  gms.  119  gms.  107  gms, 

Pat     56  gms.  51  gms.  65  gms. 

Carbohydrates 500  gms.  531   gms.  407   gms. 

On  the  consideration  of  the  food  substances  necessary  for  the  mainte- 
nance of  the  health  and  growth  of  the  body — namely,  the  proteins,  fats, 
carbohydrates,  mineral  salts,  and  water — it  has  been  assumed  that  the 
mixed  diet  used  will  contain  a  sufficient  quantity  of  mineral  salts  and  of 
water  for  proper  building  up  and  repair  of  the  body.  Such  beverages  as 
coffee  and  tea,  although  of  great  value  in  the  menu,  furnish  no  nutritive 
substances  and  therefore  are  not  considered. 


20 


A  Dietary  Study, 


KANSAS  STATE  INDUSTRIAL  REFORMATORY. 
TABLE  C. — Per  cent  classi^^cction  of  rroups  of  foods  for  rach  of  eight  months. 


Classes  of  Foods. 


Breadstuffs 

Vegetables 

Fruits : . . . 

Sugar,  sirup 

Lard,  butter,  butterine 

Milk,  cheese,  eggs 

Meptp,  fowls.  *^sVi 


July 
and 

Aug. 

Sept. 

Oct. 

Nov. 

Dec. 

Jan. 

46.98 

41.97 

30.24 

41.98 

42.12 

43.02 

15.99 

13.95 

18.22 

24.60 

13.32 

9.41 

2.97 

2.89 

7.18 

2.89 

4.38 

6.66 

8.93 

5.98 

11.95 

7.69 

7.73 

13.54 

9.99 

10.69 

12.04 

9.55 

11.76 

4.85 

6.98 

6.94 

5.82 

5.90 

5.15 

6.07 

6.(^6 

8.99 

14. ''..•^ 

13.25 

15.0-8 

16  ."^e 

Feb. 


45.34 

11.67 
5.54 

10.82 
7.78 
5.25 

13.78 


Table  C  shows  what  proportion  of  the  total  food  used  belongs  in  each 
of  seven  classes.  Breadstuffs,  vegetables  and  fruits  together  consti- 
tuted from  55.64  per  cent  of  the  food  in  October  to  68.48  per  cent  in 
November,  or  an  average  of  nearly  two-thirds  of  the  food  used.  There  is 
quite  a  variation  in  the  amount  of  sugar  and  sirup  (taken  together)  used, 
as  the  per  cent  is  twice  as  much  in  January  as  in  September.  More 
sugar  can  be  taken  care  of  by  the  body  in  winter  than  in  summer,  so 
this  difference  in  amount  is  in  the  right  direction.  The  same  thing  is 
true  of  the  animal  foods,  which  are  higher  in  percentage  used  in  the 
later  months  of  the  year. 

By  an  interigent  selection  of  foods  in  this  way — thst  is,  by  pushing  the 
use  of  cereals  and  vegetables  in  the  summer  and  allowing  more  sugar, 
fats  and  animal  foods  in  the  winter — the  health  of  the  inmates  will  be 
improved  and  the  cost  of  maintenance  will  be  decreased. 

Table  D  shows  in  rather  an  interesting  way  from  what  foods  the  pro- 
teins, fats  and  carbohydrates  are  obtained  during  each  month.  The 
analysis  of  this  table  is  perhaps  best  made  from  the  average  of  the 
eight  months,  although  the  monthly  variations  are  of  interest. 

Since  proteins  from  vegetable  sources  are  usually  much  cheaper  than 
those  from  animal  sources,  the  use  of  vegetable  proteins  should  be  en- 
couraged whenever  this  can  be  done  without  sacrifice  of  health  condi- 
tions. Although  it  is  probably  true  that  a  diet  containing  protein  en- 
tirely from  peas,  beans  and  cereals  would  not  be  satisfactory,  yet  there  ^ 
is  little  danger  of  crowding  the  vegetable  diet  too  far  under  present 
conditions.  With  more  than  a  third  of  the  protein  (35  per  cent)  com- 
ing from  animal  sources,  there  is  no  danger  of  an  excess  of  vegetable 
protein;  in  fact,  the  animal  protein  might  be  much  decreased  without 
ultimate  deficiency  in  this  class  of  nutrients. 

Looking  for  the  source  of  the  fat  in  the  diet,  it  is  evident  that  at 
least  55  per  cent  of  it  is  of  animal  origin.  The  butterine  and  oleo  and 
the  compound  lards  are  largely  of  vegetable  origin.  While,  as  before 
stated,  milk,  cheese  and  eggs  should  be  used  as  freely  as  possible,  the 
oleo  and  compound  lards  for  shortening  (all  vegetable  fats)  may  be 
used  to  replace  fat  pork  and  the  fat  of  beef.  This  means  a  saving  of 
animal  fats  for  export  and  a  reduction  of  cost  by  the  purchase  of 
vegetable  fats. 

There  is  not  so  much  to  be  said  of  the  source  of  the  carbohydrates, 
for  bread  and  breadstuffs  must  furnish  at  least  one-half.     The  free  use 


state  Induistridl  Reformatory. 


21 


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22  A  Dietary  Study. 

of  peas,  beans,  potatoes  and  vegetables  releases  some  of  the  cereals  for 
export,  and  tends  to  diminish  cost  of  maintenance.  The  rather  abundant 
use  of  saccharine  products  has  already  been  discussed.  It  is  understood 
that  at  least  25  per  cent  of  vegetable  substitute  is  u^ed  v^^ith  the  cere^s. 
If  corn  is  the  substitute  selected,  a  fresh  bolted  corn  meal,  made  from  the 
whole  grain,  is  more  nutritious  than  a  corn  flour  made  from  the  de- 
germinated  cereal. 

SUMMARY. 

1.  In  order  that  a  satisfactory  check  may  be  kept  on  the  actual  amount 
of  food  used,  it  is  advisable  to  see  that  only  the  food  actually  used  for 
each  period,  say  of  a  month,  be  charged  to  the  kitchen. 

2.  The  amount  of  sugar  used  should  be  decreased  as  much  as  possible, 
but  this  may  partially  be  replaced  by  sirup,  which  is  made  mostly  from 
corn.  Sorghum  can  be  raised  in  large  quantities,  and  the  use  of  this 
sirup  will  decrease  the  cost  of  maintenance. 

3.  Increase  the  amount  of  milk  used  as  rapidly  as  possible.  It  is 
not  only  a  valuable  food,  but  it  contains  certain  little-known  substances, 
often  called  "vitamines,"  that  are  essential  to  growth  and  bodily  vigor, 

4.  There  would  probably  be  no  loss  in  physical  and  mental  powers 
of  the  inmate?,  by  cutting  down  the  total  amount  of  food  used  ten  per 
cent.  The  proportion  of  the  different  food  constituents  is  quite  satis- 
factory. 

5.  The  intelligent  selection  of  the  foods  used,  so  that  less  fat,  meat 
and  sugar  are  used  in  the  warmer  months,  and  more  vegetables  and 
fruits,  will  tend  to  improve  the  health  of  the  inmates  and  at  the  same 
time  will  result  in  a  diminished  cost. 

6.  Use  vegetable  protein  as  much  as  possible,  at  the  same  time  de- 
creasing that  from  animal  sources,  with  the  exception  of  milk.  Raise  as 
many  vegetables  as  possible  on  the  farm,  and  can  or  dry  for  winter  use. 

7.  Since  it  is  now  possible  to  obtain  butter  substitutes  made  from 
the  vegetable  oils,  and  lard  substitutes  mainly  from  the  same  source, 
there  is  no  objection  to  using  as  much  of  these  as  is  necessary  to  yield 
the  fat  required. 

8.  In  the  use  of  wheat  substitutes,  use  fresh  corn  meal. 

9.  Hoover's  estimate  of  the  amount  of  sugar  necessary  per  day  per 
capita  is  1.58  ounces,  while  the  average  used  in  this  institution  is  2.21 
ounces.  The  sugar  may  therefore  be  diminished,  while  any  deficit  may, 
if  necessary,  be  made  up  by  the  use  of  sirup. 

10.  If  it  is  possible  in  the  vicinity  of  Hutchinson  to  make  arrange- 
ments to  serve  fish,  or  if  salted  or  frozen  fish  can  be  obtained  for  a 
portion  of  the  year,  the  diet  would  be  improved  without  increased  cost. 


111. 

OSAWATOMIE  STATE  HOSPITAL. 

(Abstract  of  Report.) 

OUTLINE  OF  INVESTIGATION. 

Lawrence,  Kan  ,  September  26,  1918. 

The  dietary  of  the  institution  for  ten  months,  beginning  July,  1917,  was 
furnished  by  Supt.  F.  A.  Carmichael.  In  each  case  the  quantity  of  food 
used  or  issued  to  the  kitchen  was  reported  for  each  variety  of  food. 

Table  A  shows'  the  total  amount  of  each  food  for  each  month,  from 
which  is  computed  the  pounds  of  protein,  of  fats  and  of  carbohydrates, 
and  the  total  calories.  A  summary  for  each  month,  with  the  computation 
of  the  amount  per  day  per  capita,  is  given. 

As  illustrative  of  this  table,  the  food  used  for  the  month  of  October 
only  is  given,  but  all  ten  months  are  considered  in  the  summary. 

Table  B  shows  the  per  cent  of  two  food  nutrients  obtained  from  each  of 
eight  classes  of  food  for  each  month. 

Table  C  gives  a  comparison  of  the  per  capita  use  of  some  of  the  im- 
portant staples  for  each  of  the  ten  months. 

Table  D  gives  a  comparison  of  the  dietaries  for  each  of  the  ten  months, 
showing  the  per  cent  of  calories  per  capita  of  total  calories. 

Table  E  is  a  summary  of  the  dietaries  for  the  ten  months,  showing  the 
per  capita  use  of  food,  and  the  cost. 

(23) 


24 


A  Dietary  Study. 


OSAWATOMIE  STATE  HOSPITAL. 
TABLE  A.— Dietnry  for  October,  1917. 


Articles  of  Food. 

Weight, 
pounds. 

Protein, 

pounds. 

Fat, 
pounds. 

Carbo- 
hydrates, 
pounds. 

Calories. 

Apples,  canr.ed 

Apples,  dried 

387.50 

1,000.00 

3,420.00 

225.00 

109.00 

35.00 

20.00 

1,460.00 

723.00 

675.00 

885.00 

9,681.00 

1,358.00 

185.00 

13,K0.00 

4.00 

144.00 

336.00 

481.00 

46.00 

17.00 

30.00 

7.00 

fO.OO 

17.00 

100.00 

471.50 

116.00 

464.00 

1,249.00 

320.00 

750.00 

25,400.00 

1.50 

57.00 

500.00 

1.641.00 

P30.00 

1,000.00 

398.00 

69.00 

520.00 

2,020.00 

20.00 

120.00 

240.00 

30,538.00 

876.00 

3,000.00 

385.00 

38.50 

36.00 

231.00 

500.00 

675.00 

315.00 

1,590.00 

152  00 

1,472.00 

169.00 

55,040.00 

7,300.00 

1,000.00 

500.00 

114.00 

1.01 
16.00 
10.26 

8.10 
10.35 

8.10 
22.00 
10.26 

183.60 
681.00 
369.36 
155.70 

377,000 

1,350,000 

731  880 

Apricots 

306  000 

Bacon 

64.74 

283  073 

Baking  powder 

10.50 

2.86 

870.16 

476.45 

46.57 
527.46 

19  040 

Bananas 

.16 

328.50 

130.86 

14.17 

189.12 

1,403.74 

17.65 

1.48 

184.66 

.06 

1.29 

3.64 

138.52 

7.30 

2.19 

.33 

.44 

2.52 

.08 

26.28 

10.84 

2.02 

15.93 

1,626.40 

1.35 

3.88 

26.38 

.00 

.14 

.28 

172.67 

5.65 

8.27 

.12 

4.01 

1.08 

5,800 
2,283,440 
1  146  678 

Beans,  Lima 

119,400 
1  384,140 

Beef 

9,487,380 
226  786 

Beets 

104.56 

104.34 

633.12 

.49 

3.74 

72.59 

1.44 

207  940 

Cabb.ige 

1,582,800 

Catsup 

1  060 

Celery.... 

9  792 

139  440 

Cheese .... 

957  114 

Chicken 

34  546 

Chocolate 

5.15 

1.20 

2.20 

17.10 

15.30 

69.70 

344.66 

85.60 

12.06 

47  134 

3,330 

Cocoanut 

21  F6 

Corn 

40,050 

Cornstarch   .  . . .' 

27  744 

9.70 

46.20 

11.60 

3.24 

148.63 

3.S4 

32.25 

2,844.80 

1.37 

1.70 

41.50 

233.02 

77.19 

12.10 

42.90 

10.72 

.92 

116.15 

.96 

2.25 

254.00 

.00 

1  3,500 

Crackers,  soda   .... 

884  062 

220,864 

Cucumbers 

SI  552 

Eggs 

743,155 

Eggplant 

16.32 

556.50 

19,024.60 

40  640 

Figs 

1,077,750 

Flour,  white 

40  716  200 

Gelatine 

2,493 

Gooseberries ... 

22.40 
395.00 

43  604 

Grits 

3.00 

548.09 

5.58 

1,000.00 

398.00 

.34 

4.68 

147.46 

.38 

.12 

22.22 

1,221.52 

128.77 

2,4t;0.00 

1.15 

.04 

.86 

.23 

5.00 

2.70 

.94 

3.18 

1.06 

806.65 

133.17 

5.04 

43.80 

804,000 

Ham 

2,C60  061 

734.70 

1.495,440 

Lard 

4,0^^2  000 

1,624,636 

Lemons 

.48 

69.68 

337.34 

l.?4 

.24 

23.04 

1,007.75 

132.27 

36.00 

5.38 

.23 

3.16 

1.61 

23.50 

3.37 

.94 

57.24 

.60 

110.40 

9.97 

90.72 

102.20 

21.00 

13.00 

.91 

4.07 

385.32 

1,337.24 

15.08 

3.24 

26.88 

1,526.90 

9,660 

Mac  ironi 

844,480 

Meal,  oat 

3,642,060 

Me»l,  corn 

32,260 

Melons 

6,840 

Milk,  condensed 

181,680 

Milk 

9,588,932 

Mutton 

765  624 

10,230,000 

Onions 

34.26 

3.27 

1.40 

24.94 

312.50 

85.72 

56.70 

155.82 

55.32 

76,615 

Oranges 

6,506 

Oysters .  .  . 

1 1 , 808 

Peaches,  canned     

49,203 

Peaches,  dried 

645,000 

Pears,  fresh . 

172,800 

Pears,  canned. 

108,360 

Peas 

399,090 

Pineapple 

105,792 

Pork,  fresh 

3,613  760 

Pork,  salt 

580,515 

Potatoes,  Irish 

740.88 

1,598.70 

733.00 

380.50 

64.29 

1,532,160 

Potatoes,  sweet 

3,263.100 

Prunes 

1,400  000 

Raisins 

16.50 
2.39 

802,500 

Raspberries 

131.100 

Osawatomie  State  Hospital. 


25 


T.4BLE  A.— Concluded. 


Articles  op  Food. 


Weight, 
pounds. 


Protein, 
pounds. 


Fat, 
pounds. 


Carbo- 
hydrates, 
pounds. 


Calories. 


Rice 

Suet ■; 

Salmon 

Sardines 

Sausage,  Vienna 

Sugar,  granulated 

Sugar,  powdered 

Sirup 

Spaghetti 

Tapioca 

Tomatoes,  canned 

Tomatoes,  fresh 

Turnips 

Wheat,  cracked 

Yeast.; 

Totals 

Amount  per  day  per  capita 


55.00 

138.00 

192.00 

12.00 

788.50 

5,100.00 

20.00 

4,590.00 

135.00 

46.00 

3,408.00 

11,480.00 

217.00 

90.00 

120.00 


201,235.50 


4.40 

9.48 

37.44 

2.84 

220.78 


112.88 

14.40 

2.36 

174.25 


43.45 


8,441.91 


4.23 


16.33 

.54 

.18 

.04 

40.89 

6.81 

103.32 

45.92 

1.95 

.21 

9.99 

1.53 

14.04 

.48 

48.09 

,100.00 

20.00 

,694.95 

103.00 

40.48 

136.32 

347.72 

12.37 

67.95 

25.29 


87,505 

472,650 

126,720 

14,652 

1,170  922 

9,251,400 

36,280 

6,660,090 

218,700 

73,968 

248,024 

1,182,440 

26,r08 

135,090 

73,200 


,803.03 


42,731. 


133,391,114 


117  sTPms 


403  rrrairs 


2,973 


26 


A  Dietary  Study. 


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28  A  Dietarij  Study. 

Table  B,  part  first,  answers  the  question,  Where  did  the  proteins  come 
from?  There  is  some  irregularity,  as  would  be  expected  in  a  summary  of 
this  kind.  It  will  be  noted,  however,  that,  on  the  average,  most  of  the 
protein,  namely,  37.91  per  cent,  comes  from  the  cereals,  including,  of 
course,  bread.  This  is  as  it  should  be.  The  next  source  of  protein  is 
beef,  mutton,  etc.,  which  yield  20.65  per  cent  of  the  protein;  and  the 
third  is  cheese,  milk  and  eggs,  which  yield  17.17  per  cent  of  the  protein. 
Dry  beans  yield  6.21  per  cent  and  the  fruit  and  vegetables  6.12  per  cent. 
Potatoes,  which  are  very  poor  in  protein,  yield  5.28  per  cent.  Pork  yields 
a  very  little  protein,  namely,  4.06  per  cent.  A  suggestion  will  be  made  in 
regard  to  the  protein  in  the  final  discussion  of  results.  It  is  interesting 
to  note  that  the  average  per  cent  of  protein  for  the  ten  months  from 
animal  sources  is  approximately  44  per  cent,  and  from  vegetable  sources 
56  per  cent.  S'nce  vegetable  proteins  are  generally  cheaper  than  those 
from  animal  sources,  this  proportion  is  in  the  interest  of  less  expense. 

Table  B,  part  second,  answers  the  question.  What  is  the  source  of  the 
fats  in  the  diet?  An  examination  of  this  table  shows  that  the  largest 
amount,  namely,  24.68  per  cent,  comes  from  oleomargarine.  This  is 
closely  followed  by  beef  and  mutton,  which  furnish  20.64  per  cent  of  the 
fat.  The  milk,  cheese  and  eggs  yield  17.41  per  cent  of  the  fat,  while  pork 
yields  15.93  per  cent  of  the  fat,  compound  lard  and  sausage  11.47  per  cent 
of  the  fat,  and  other  sources  are  negligible. 

An  examination  of  table  C  will  give  some  idea  of  the  regularity  or 
irregularity  of  the  supply  of  materials.  In  some  cases  this  may  be 
slightly  misleading,  as,  for  instance,  only  a  small  quantity  of  Irish  pota- 
toes was  dispensed  in  October.  This  is  no  doubt  made  up  for  by  the  larger 
amount  in  September,  and  also  by  the  issuance  of  more  sweet  potatoes 
than  in  any  other  month.  It  is  interesting  to  note  that  the  amounts  of 
sugar  per  capita  began  to  decrease  in  November  and  continued  to  de- 
crease until  the  end  of  the  period.  The  average  was  1.38  ounces  per  day 
per  capita.  The  less  amount,  0.92  ounce,  as  reported  for  April,  is  just 
about  the  amount  at  present  allowed — that  is,  two  pounds  per  month  per 
capita — by  the  Food  Administrator.  I  have  no  doubt  that  this  low  con- 
sumption of  sugar  is  continued  at  the  present  time.  A  part  of  the  sugar 
is  replaced  by  sirup,  as  during  April,  with  the  lowest  sugar  report,  we 
find  the  highest  amount  of  sirup  used. 

The  amount  of  beef  and  mutton  used  is  fairly  uniform,  with  the  ex- 
ception of  January.  It  is  possible  that  in  this  case  the  figures  refer  to 
the  amount  put  in  storage  rather  than  to  the  amount  actually  consumed. 
In  regard  to  the  use  of  milk,  every  effort  should  be  made  to  increase  as 
much  as  possible  the  amount  used.  In  the  system  of  dietetics  now  recom- 
mended a  larger  amount  than  the  13  ounces  here  dispensed  would  be  ad- 
visable, to  preserve,  as  far  as  possible,  the  health  of  the  patients.  In  re- 
gard to  dried  fruits,  also,  the  amount  used  should  be  increased  as  much 
as  possible. 

A  study  of  table  E  shows  several  interesting  points.  First  is  the 
grams  of  the  protein  per  capita.  This  runs  from  72  grams  in  July  to 
95  grams  in  January.  This  is  probably  a  little  low  for  patients  of  this 
class.     The  protein  is  higher  in  the  later  months,  which  is  a  commend- 


Osawatomie  State  Hospital. 


29 


OSAWATOMIE  STATE  HOSPITAL. 
TABLE  E. — Summaries  of  dietaries  for  ten  months. — Per  capita  use  of  food. 


DiKTARIES. 


Weight 
of  food, 
pounds. 


Protein, 
grams. 


Fat, 
grams. 


Carbo- 
hydrates, 
grams. 


Calories. 


Cost 

per  day 

per  capita. 


1917, 

July 

August 

September 

October 

November 

December 

1918. 

January 

February 

March 

April 

Averarre.  .  . 


2.45 
3.12 
3.58 
3.18 
3.51 
3.52 


3.23 
3.36 
3.64 
3.17 


81 


75.0 
05.0 
108.0 
117.0 
104.0 
122.0 


101.0 

95.0 
117.0 
95.0 


3  27 


102.0 


414 
403 
3<'0 
403 
562 
403 


400 
381 
412 
412 


2,641 
2,925 
2,880 
2,973 
3,047 
3,114 


2,603 
3,102 
2.901 


$0,107 
.222 
.220 
.208 
.226 
.239 


.205 
.221 
.249 
.211 


able  feature  of  the  diet.  In  the  next  to  the  last  column  is  given  the 
calories  per  capita.  A  comparison  of  this  list  shows  a  variation  from 
2,603  to  3,114,  which,  all  things  considered,  is  not  too  great  a  variation, 
and  is  higher  in  November,  December  and  March  than  in  other  months. 
The  February  figure,  2,603,  is  a  little  low  for  a  winter  month.  The 
average  fcr  the  entire  period  corresponds  fairly  well  with  the  best  prac- 
tice, and  is  probably  high  enough,  but  the  pote'n  ratio  should  be  changed 
a  little  so  that  more  protein  would  be  dispensed  and  less  fat  or  carbo- 
hydrates. This  protein  could  readily  be  made  up  if  the  amount  of  milk, 
cheese  and  eggs  could  be  increased,  or  by  the  use  of  a  little  more  animal 
food.  Table  E  also  allows  a  comparison  in  grams  of  the  protein,  fat  and 
carbohydrates,  but,  in  addition,  the  fact  is  brought  out  that  the  prote.n 
should  be  slightly  increased  at  the  expense  either  of  the  fats  or  of  the 
carbohydrates.  In  regard  to  the  cost  per  month,  when  the  high  cost  of 
food  is  considered,  the  average  per  capita  per  day  of  21.9  cents  seems  to 
be  very  satisfactory. 

SUMMARY. 

1.  The  first  conclusion  is  that  in  general  the  food  supplied  is  sufficient 
in  quantity. 

2.  Comparing  the  proportion  of  the  different  materials  to  make  a 
well-balanced  ration,  it  is  suggested  that  more  protein  be  furnished  and 
that  at  the  same  time  the  amount  of  fats  and  carbohydrates  be  diminished 
so  that  the  total  number  of  calories  furnished  shall  not  be  any  greater. 

3.  The  protein  may  be  increased  by  using  more  milk,  cheese  and  eggs; 
or  if  tliis  is  not  practicable,  by  the  use  of  a  little  more  lean  meat. 

4.  The  cost  of  maintenance  seems  to  be  as  low  as  could  be  expected 
when  the  increased  cost  of  all  staples  is  considered. 

5.  The  superintendent  or  the  dietician  who  has  charge  of  the  food 
should  so  dispense  it  that  the  amount  of  all  food  be  somewhat  increased 
in  the  winter  months.  This  applies  especially  to  the  fat  and  carbo- 
hydrates. Table  D  shows  that  more  of  the  energy  of  the  food  was  ob- 
tained from  meats  during  December,  January  and  February  than  during 
any  other  months,  and  that  is  as  it  should  be. 


30  A  Dietary  Study, 

6.  The  amount  of  fruit,  fresh  and  dried,  should  be  increased  as  much 
as  possible.  An  average  of  six  per  cent  of  the  total  calories  (energy) 
was  obtained  from  this  source. 

7.  The  amount  of  milk  used  should  be  increased.  It  is  well  to  note 
that  a  quart  of  milk  has  a  food  value  of  650  calories  and  is  equal  to  more 
than  a  half  pound  of  bread,  to  a  pound  of  baked  beans,  or  to  six  pounds 
of  potatoes.  It  should  be  regarded  as  a  food  and  not  a  beverage.  Milk 
has  also  exceptionally  valuable  properties  which  stimulate  growth  and 
bodily  vigor. 

8.  In  the  interests  of  economy,  continue  to  use  butter  substitutes  made 
from  vegetable  oils,  lard  substitutes  from  the  same  source,  and  sugar 
substitutes  made  from  cornstarch. 

9.  If  fresh,  salted  or  frozen  fish  could  be  obtained  for  use  during  a 
portion  of  the  year  the  diet  would  be  improved  without  increased  cost. 

Supplementing  this  report,  a  study  was  made  of  each  food  served  for 
the  tl  ree  meals  both  on  the  patients*  and  the  employees'  table  for  three 
days  during  the  summer  of  1918.  As  an  illustration,  to  the  patients  for 
breakfast  was  served  oatmeal,  milk,  meat  and  potato  stew,  bread,  sirup, 
coffee;  for  dinner,  cold  sliced  ham,  mashed  potatoes,  stewed  tomatoes, 
bread,  butter  and  tea;  for  supper,  boiled  rice,  apple  sauce,  cheese,  sweet 
crackers,  bread,  butter  and  tea.  The  average  of  protein  for  patients  was 
91.05  grams,  and  for  employees,  111.85  grams.  This  is  not  a  larger 
difference  than  would  be  expected  between  the  two  classes  of  people. 
The  calories  were  2,905  and  3,278,  respectively. 


IV. 

GIRLS'  INDUSTRIAL  SCHOOL,  BELOIT. 

(Abstract  of  Report.) 


Lawrence,  Kan.,  December  24,  1918. 
The  dietary  for  this  institution  from  September  1,  1917,  to  August  31, 
1918,  both  inclusive,  was  sent  me  by  T.  E.  Baird,  steward.     In  making 
the  abstract  of  the  report  I  have  given  in  detail  only  that  for  October, 
1917,  which  is  as  follows: 

GIRLS'  INDUSTRIAL  SCHOOL. 
TABLE  A.— Dietary  for  October,  1917. 


Articles  of  Food. 


Apples,  cauned 

Apricots 

Baking  powder 

Beans,  string 

Beef 

Beets 

Blackberries 

Butter 

Butterine 

Carrots 

Catsup 

Cherries 

Cheese 

Chocolate 

Corn  flakes 

Cornstarch 

Crackers,  soda 

Eggs 

Flour,  white 

Flour,  Graham 

Gelatin 

Gooseberries 

Hominy 

Lard 

Macaroni 

Meal,  corn 

Milk 

Oysters 

Peaches 

Pears 

•Peas 

Pineapple 

Pork,  fresh 

Potatoes,  Irish 

Potatoes,  sweet 

Pumpkins 

Sahnon 

Sardines 

Sugar,  brown 

Sugar,  granulated 

Sirup 

Tomatoes 

Yeast 

P'    Totals 

Amount  per  day  per  capita 


Weight, 
pounds. 


396.00 

180.00 

40.00 

120.00 

613.00 

42.00 

60.00 

145.00 

120.00 

264.00 

18.00 

72.00 

76.00 

36.00 

378.00 

48.00 

309.00 

106.50 

1,000.00 

200.00 

180.00 

90.00 

399.00 

400.00 

35.00 

300.00 

9,647.50 

90.00 

270.00 

180.00 

330.00 

180.00 

311.00 

1,140.00 

50.00 

99.00 

240.00 

60.00 

300.00 

800.00 

180.00 

296.00 

16.00 


19,817.00 


3.41 


Protein, 
pounds. 


0.79 

1.62 

.00 

1.32 

88.88 

.54 

.48 

1.45 

1.44 

2.37 

.27 

.64 

21.88 

4.74 

20.79 

.00 

30.28 

12.67 

112.00 

27.60 

164.52 

.99 

33.11 

.00 

4.69 

27.60 

318.36 

7.92 

1.89 

.54 

11.88 

.72 

23.32 

20.52 

.70 

.79 

46.80 

13.80 

.00 

.00 

.00 

4.75 

1.87 


1,014.53 


Fat, 
pounds. 


3.16 

.00 

.00 

.12 

102.98 

.04 

1.26 

123.25 

99.60 

.52 

.03 

.57 

27.28 

17.53 

5.67 

.00 

28.11 

9.90 

10.00 

3.80 

.18 

.00 

2.39 

400.00 

.31 

5.70 

385.90 

2.16 

.27 

.54 

.66 

1.26 

170.42 

1.14 

.30 

.19 

18.00 

11.82 

.00 

.00 

.00 

.79 


1,435.93 


Carbo- 
hydrates, 
pounds. 


147.31 
31.14 
12.00 
4.56 
.00 
3.23 
33.84 


.00 

19.53 

2.21 

11.44 

.22 

10.90 

306.18 

43.20 

225.87 

.00 

749.00 

143.80 

.00 

18.99 

315.21 

.00 

25.93 

226.20 

482.37 

3.51 

29.16 

32.40 

32.34 

65.52 

.00 

167.58 

10.95 

6.63 

.00 

.00 

285.00 

800.00 

144. &0 

15.84 

3.36 


4,410.32 


Calories. 


,289,080 
61,200 
21,760 
11,160 

600,740 

7,014 

67,440 

505,760 

409,760 

41,976 

4,770 

24,336 

151,544 
99,792 

616,518 
78,336 

579,375 

63,367 

1,603,000 

326,600 

299,160 
37,350 

614,592 

1,632,800 

56,840 

483,900 
3,029,315 

•  19,980 
57,510 
61,920 
82,830 

125,280 

763,505 

346,560 
22,350 
14,850- 

158,400 
73,260 

517,200 
1,451,200 

261,180 

40,788 

9.760 


15,694,058 


2.707 


(31) 


32 


A  Dietary  Study. 


SUMMARY  AND  DISCUSSION. 

Referring  to  the  tables  herewith  submitted  of  the  dietary  for  each 
month  from  September,  1917,  to  September,  1918,  these  tables  show 
considerable  irregularity  in  the  amount  of  food  issued.  I  called  your 
attention  to  this  fact  and  learned,  through  the  superintendent,  that  this 
was  due  to  the  peculiar  conditions  at  this  institution,  as  they  had  no 
storeroom  where  it  was  possible  to  keep  a  large  proportion  of  the  stock 
on  hand.  Such  items  as  fruit,  vegetables,  etc.,  must  be  kept  in  the  re- 
frigerators in  the  kitchens,  so  they  were  at  all  times  accessible  to  the 
steward  and  could  not  be  issued,  as  in  most  of  the  other  institutions,  on 
a  daily  requisition  to  the  storeroom.  This  accounts  for  many  of  the 
irregularities  appearing  in  the  tables. 

In  reference  to  the  use  of  butter  and  butterine  (table  A),  it  is  noticed 
that  the  use  of  butterine  increased  from  the  beginning  of  the  year,  so 
that  it  was  from  twice  to  three  times  as  much  as  butter.  This  practice  is 
to  be  commended.  Although  considerable  butter  should  be  used,  it  is 
by  no  means  necessary  to  have  more  than  one-third  of  the  butter  fat  in 
that  form. 

The  amount  of  milk  decreased  from  2,054  gallons  in  January  to  777  in 
August.    The  larger  amount  used  should  be  kept  up  if  possible. 

The  calories  obtained  from  the  sugar  were  much  more  than  those 
from  the  sirup.  The  sweetening  is  of  practically  equal  value,  whether 
obtained  from  sugar  or  sirup,  and  in  many  of  the  institutions  a  large 
proportion  of  the  sweetening  is  obtained  from  sirup  on  account  of  its 
cheapness. 

The  use  of  corn  meal  began  to  increase  in  the  spring  months.  The 
increasing  use  of  this  carbohydrate  is  to  be  commended. 

GIRLS'  INDUSTRIAL  SCHOOL. 
TABLE  B. — Summaries  of  dietaries  for  twelve  months. — Per  capita  use  of  food. 


Dietaries 


Attend- 
ance. 


Weight 
of  food, 
pounds. 


Protein, 
grams. 


Fat, 


Carbo- 
hydrates, 
grams. 


Calories. 


Cost 
per 
day. 


September . 
October. . . 
November . 
December. 


1917. 


January. . 
February . 
March . .  . 
April.  .  . . 
May.  .  .  . 

June 

J"ly 

August.  . 


1918. 


5,490 

5,797 
5,670 
5,797 


5,859 
5,292 
5,735 
5,520 
5,859 
5,850 
6,907 
6,138 


Average . 


4.47 
3.41 
5.21 
5.39 


5.85 
5.55 
4.69 
5.72 
4.59 
3.39 
3.74 
3.04 

4.58 


95 

77 
104 


104 
104 
81 
108 
108 
81 
72 
68 


108 
151 
131 


145 
118 


549 
344 

462 
462 


494 
408 
381 
553 
462 
385 
385 
276 


3,404 
2,707 
3,821 
3,483 


3,742 
3,109 
2,685 
3,511 
3,267 
2,820 
2,574 
2,234 


$0. 


.18 
.21 
.16 


106 


430 


3,113 


175 


From  table  B  it  is  noted  that  the  protein  varies  from  68  grams  to 
104  grams.  This  variation  may  be  partly  due  to  the  irregularities  of  is- 
suing the  food  as  noted  above.  The  fat  per  day  per  capita  varies  from 
81  grams  in  July  to  151  grams  in  November.     This  variation  is  in  the 


Girls'  Industrial  School.  33 

right  direction,  and  it  is  noticed  that  in  general  more  fat  was  supplied 
in  the  fall  and  winter  than  in  the  summer,  as  should  be  the  case. 

Table  B  is  a  summary  of  the  dietaries  for  the  twelve  months,  and 
this  also  shows  considerable  irregularity,  but  that  would  have  but  little 
bearing  on  the  average.  The  weight  of  food  is  4.58  p.ounds  per  day  per 
capita,  and  the  protein  shows  an  average  of  91  grams.  This  amount  is 
a  little  low,  as  most  authorities  agree  that  for  growing  girls — although 
as  much  may  not  be  required  as  for  men  at  ordinary  labor — something 
over  100  grams  should  be  provided.  The  proportion  of  fat  to  protein,  an 
average  of  106  to  91,  is  fairly  satisfactory.  This  fat  comes  from  butter, 
oleomargarine,  lard,  milk  and  beef.  It  is  important  that  milk  and  butter 
should  be  retained  at  as  high  a  proportion  as  possible.  The  cal- 
ories as  noted  on  this  table  are  quite  irregular  in  the  different  months, 
varying  from  2,234  to  3,821.  I  am  convinced  that  this  variation  in  the 
amount  of  energy  in  the  food  dispensed  does  not  represent  the  actual 
condition  at  the  institution,  for  the  variation  is  greater  than  could  be 
expected.  The  average  of  3,113  is  fairly  satisfactory,  considering  the 
character  of  the  inmates,  but  a  variation  of  over  60  per  cent  in  the  cal- 
ories from  August  to  November  would  not  be  expected. 

Table  C  gives  the  amount  of  some  of  the  important  staples  used  for 
each  month.  The  per  cent  by  months  is  of  no  value,  for  the  reason 
above  stated,  but  the  average  in  ounces  per  day  per  capita  can  be  stated. 
This  is  shown  in  the  last  column.  This  indicates,  among  other  things, 
that  6.08  ounces  of  flour  is  used  by  each  person  per  day.  The  amount  of 
sugar  decreased  during  the  year,  the  average  being  1.75  ounces  per  day, 
or  3.25  pounds  per  month  per  capita.  This  is  more  than  the  ration  which 
was  in  effect  under  the  Food  Administration  of  two  pounds  per  month 
per  capita.  The  sirup,  in  terms  of  sugar,  amounted  to  3.75'  pounds  for 
the  month.  This  might  well  have  been  decreased  so  as  to  bring  the  sugar 
down  to  the  two  pounds  per  month,  as  required  by  the  Food  Administra- 
tion. The  amount  of  milk,  an  average  of  31.22  ounces,  nearly  a  quart  per 
day,  is  quite  satisfactory.  It  is  possible  that  the  three-fourths  pound  of 
potatoes  used  daily  might  have  been  somewhat  increased  to  take  the  place 
of  some  of  the  flour  or  other  cereals  used. 


3— Dietary— 575 


34 


A  Dietary  Study. 


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36  A  Dietary  Study. 

Table  D  shows  in  a  condensed  form  where  the  total  energy  expended 
comes  from.  Although  this  varies  considerably  in  the  different  months, 
due  to  the  cause  previously  mentioned,  we  can  get  a  general  idea  from 
the  figures  given.  It  is  noted  that  breadstuffs  furnish  from  one-fourth 
to  three-fifths  of  the  energy,  vegetables  about  12  per  cent,  sugar  and 
sirup  a  varying  quantity  from  3.70  to  14.20,  with  an  average  of  about  8 
per  cent.  The  amount  of  energy  furnished  by  milk,  cheese  and  eggs  is 
nearly  one-fifth  of  the  total  energy.  This  proportion  is  to  be  commended. 
Meat,  fish  and  fowls  furnish  a  small  proportion,  considerably  less  than  10 
per  cent,  of  the  energy.  Comparing  these  groups,  it  should  be  noted 
that  starch  and  other  carbohydrates  come  from  the  breadstuffs  and 
vegetables,  fruits  and  sugar;  lard,  butter,  oleomargarine,  eggs,  milk  and 
meat  furnish  most  of  the  fat;  and  the  milk,  eggs  and  meat  furnish 
most  of  the  protein.  It  would  be  possible  to  increase  the  protein,  as 
previously  suggested,  by  bringing  up  the  amount  of  milk,  cheese,  eggs 
and  meats. 

Table  B  shows  also  the  cost  per  day  per  capita.  It  is  noted  that  the 
population  varies  within  narrow  limits,  but  the  cost  per  month  varies 
within  wide  limits.  This  is  due  to  the  conditions  of  storage,  as  previously 
noted,  and  affects  the  cost  per  day  per  capita  from  11  cents  to  29  cents. 
The  average  of  this,  17.5  cents,  no  doubt  represents  the  actual  cost,  and 
is  commendably  low. 

RECAPITULATION. 

1.  The  value  of  the  monthly  study  of  the  dietaries  at  this  institution 
is  much  impaired  by  the  fact  that  the  provisions  cannot  be  issued  daily 
from  the  storeroom.  An  imperative  need  of  this  institution  is  a  com- 
modious warehouse  and  storeroom  for  taking  care  of  the  supplies  issued. 
This  will  be  a  great  saving  in  handling  and  also  in  preventing  waste. 

2.  The  amount  of  milk  used  is  large,  and  this  practice  should  be  con- 
tinued, with  the  attempt  to  keep  up  the  maximum  quantity  throughout 
the  entire  year. 

3.  A  part  of  the  sugar  used  might  be  replaced  by  sirup  with  no  loss 
to  the  nutritive  ratio,  and  at  less  cost. 

4.  The  protein  used  should  be  somewhat  increased.  Although,  as 
above  stated,  the  amount  of  milk  used  is  large,  the  beef  and  vegetable 
protein  like  beans,  peas,  etc.,  should  be  increased  to  bring  up  the  protein 
value  to  at  least  105  grams. 

5.  The  total  amount  of  food  is  probably  a  little  low  for  inmates  of 
this  character — that  is,  a  little  more  generous  feeding  should  be  prac- 
ticed, and  this  increase  can  be  wherever  most  convenient,  but  some  of  it 
must  be  in  meat  and  in  vegetable  proteins.  It  is  possible  that  if  greater 
regularity  of  calories  furnished  could  be  secured  the  total  amount  as  it 
stands  might  be  high  enough. 

6.  The  cost  per  month  as  compared  with  other  institutions  is,  of 
course,  low,  and  it  would  be  advisable  to  improve  the  quality  even  if  the 
cost  is  raised  three  or  four  cents. 


V. 

TOPEKA  STATE  HOSPITAL. 

(Abstract  of  Report.) 


Lawrence,  Kan.,  November  11,  1919. 

Following  is  an  abstract  of  the  report  on  the  dietary  of  the  Topeka 
State  Hospital: 

Table  A  represents  the  total  food  that  was  used  during  the  year  be- 
ginning October,  1917,  with  a  study  on  the  amount  of  nutritive  ma- 
terial derived  from  each  food.  In  all  cases  the  weight  of  the  food  as 
purchased  is  used  in  making  the  calculations.  On  making  an  abstract 
of  the  report  I  have  given  in  detail  here  only  the  figures  for  September, 
1918. 

Table  A  here  given,  which  covers  the  dietary  in  the  Topeka  State 
Hospital  for  the  year  ending  September  30,  1918,  shows  the  actual 
weight  of  each  food  issued  per  month,  the  actual  number  of  pounds  of 
protein,  fat  and  carbohydrates  for  each  month,  and  the  calories,  denoting 
the  energy  value  of  each  of  the  foods.  This  means  that  from  the 
analysis  of  each  of  these  foods  we  have  the  per  cent  of  the  protein,  fat 
and  carbohydrates,  from  which  we  can  readily  calculate  the  quantity  of 
each  of  these  nutrient  substances.  These  different  constituents  are  all 
necessary  for  the  maintenance  of  bodily  health  and  strength,  and  in 
addition  to  these,  most  foods  contain  mineral  salts,  which  are  also 
essential.  The  most  important  source  of  the  protein  foods,  as  will  be 
seen  by  an  examination  of  the  quantities  of  protein  shown  in  the  table, 
are  beef,  milk,  cheese  and  eggs.  The  fat  evidently  comes  largely  from 
the  beef,  butterine,  lard  compound,  milk,  pork  and  sausage,  and  the 
great  source  of  carbohydrates  is  flour,  crackers,  green  corn,  oatmeal, 
Irish  potatoes,  rice,  and  the  sugar  and  sirup  compounds.  Looking  over 
the  table,  furthermore,  it  will  be  noticed  that  the  greatest  quantity  of 
calories  or  energy  available  from  these  foods  comes  from  the  flour,  the 
next  in  quantity  from  beef,  followed  by  sugar  or  sirup,  then  by  milk, 
pork,  potatoes,  eggs,  butterine,  and  miscellaneous  starchy  foods.  These 
evidently  furnish  the  great  bulk  of  the  nutrients;  the  other  foods  used 
are,  however,  of  primary  importance  because  they  give  variety  to  the 
food,  and  many  of  them  furnish  mineral  salts,  which  are  also  important. 

The  important  food  ingredients  must  be  in  the  right  proportions  to 
produce  what  is  ordinarily  known  as  a  balanced  ration.  It  has  been^ 
shown  by  many  experiments  that  one  variety  of  nutrients  can,  to  a  cer- 
tain extent,  take  the  place  of  another,  but  this  cannot  be  carried  on  in- 
definitely in  the  diet  without  causing  serious  injury.  Thus  a  diet  con- 
sisting almost  exclusively  of  starchy  foods  will  ultimately  produce  a  con- 
dition similar  to  starvation,  and  man  cannot,  in  present  civilized  society 
at  least,  live  "by  meat  alone,"  although  some  uncivilized  tribes  seem  to 
live  almost  exclusively  on  fish. 

A  further  consideration  of  comparisons  in  these  tables  is  taken  up  in 
the  summaries  which  follow. 

(37) 


38 


A  Dietary  Study. 


TOPEKA  STATE  HOSPITAL. 
TABLE  A— Dietary  for  September,  1918. 


Articles  of  Food. 

Weight, 
pounds. 

Protein, 
pounds. 

Fat, 
pounds. 

Carbo- 
hydrates, 
pounds. 

Calories. 

616.00 

650.00 

84.00 

300.00 

335.00 

190.00 

1,160.00 

1,200.00 

900.00 

30.00 

100.00 

16,366.00 

385.00 

86.00 

2,760.00 

1,000.00 

325.00 

501.00 

280.00 

21.00 

.840.00 

7,377.00 

26.00 

336.00 

234.00 

375.00 

552.00 

560.00 

2,612.00 

600.00 

24,800.00 

29.00 

180.00 

^00.00 

1,025.00 

360.00 

2,750.00 

2,670.00 

43,163.00 

48.00 

6,462.00 

30.00 

90.00 

450.00 

126.00 

350.00 

1,050.00 

90.00 

225.00 

2,078.00 

18,290.00 

5,230.00 

775.00 

20,500.00 

575.00 

1,700.00 

1,500.00 

610.00 

5,460.00 

4,700.00 

25.00 

4,640.00 

864.00 

25,984.00 

2,310.00 

200.00 

50.00 

1.84 

10.40 

.75 

14.10 

31.82 

.00 

261.00 

217.20 

198.99 

.33 

2.10 

2,373.07 

5.00 

.69 

33.12 

143.00 

2.92 

144.28 

38.36 

1.32 

23.52 

88.52 

1.43 

.00 

22.69 

37.50 

54.09 

3.92 

310.82 

25.80 

2,777.60 

.29 

2.34 

66.40 

181.65 

.00 

253.00 

459.24 

1,424.37 

4.60 

90.46 

2.64 

.64 

21.15 

.37 

9.80 

37.80 

.36 

2.25 

155.85 

329.22 

73.22 

13.95 

205.00 

13.22 

136.00 

195.00 

73.81 

38.22 

.00 

.00 

.00 

10.36 

233.85 

20.79 

22.20 

5.85 

1.84 

14.30 

.00 

3.00 

198.99 

.00 

20.88 

18.00 

11.79 

.03 

.30 

2,749.48 

.38 

1.83 

2,290.80 

238.00 

.65 

179.86 

34.44 

12.05 

10.08 

29.50 

.39 

.00 

28.31 

35.25 

50.23 

1.12 

242.91 

1.80 

248.00 

.49 

2.88 

4.80 

191.03 

360.00 

52.25 

200.74 

1,726.52 

4.46 

19.38 

.72 

.00 

4.50 

.37 

18.90 

2.10 

.63 

.00 

1,138.74 

18.29 

31.38 

.00 

20.50 

17.25 

5.10 

660.00 

2.44 

10»92 

.00 

.00 

.00 

1.72 

103.93 

2.31 

3.40 

.20 

66.52 

429.64 

14.53 

187.50 

.00 

57.00 

691.36 

790.80 

591.75 

1.14 

6.90 

.00 

29,64 

49.05 

.00 

.00 

24.05 

1.50 

.00 

6,61 

159.60 

568.03 

21.06 

302.40 

163.09 

276.75 

403.51 

14.56 

.00 

445.20 

18,575.20 

3.80 

26.82 

622.00 

.00 

.00 

2,073.50 

1,820.50 

2,158.15 

5.37 

575.11 

1.16 

9,85 

281.25 

22.68 

255.15 

102.90 

32,76 

36.20 

,00 

2.688.63 

1,145.37 

482.05 

533.00 

393,87 

1,343,00 

16.50 

465.43 

245.70 

4,700,00 

25.00 

3,735.20 

34,56 

1,013.37 

131.67 

151.00 

10.50 

131,824 

856,700 

28  560 

Apples,  dried 

Apricots,  dried 

378,000 

Bacon 

869  995 

Baking  powder 

108,800 

Beans,  white 

1,814  240 

Beans,  Lima 

1,903,200 

Beans,  Mexican 

1  545,075 

Beans,  string 

2,790 

Beans,  green 

17,600 

Beef  .                       

16,038,680 
64  295 

Beets 

Blackberries,  canned 

100,050 

Butterine 

9  411  600 

Beef,  corned 

1,271,000 

Carrots 

51  675 

Cheese 

998,994 

Chickens 

210  280 

Cocoanut 

63,588 

Corn,  canned 

373  800 

1,313,106 

Corn  flakes ... 

42  406 

Cornstarch 

548,352 

Crackers,  cream 

452,790 

Crackers,  Graham , . 

714,000 

Crackers,  soda 

1  035  000 

38,082 

Eggs 

1  554  140 

pS :::::::::;:::;::::::::::■■ 

862,200 

Flour 

39  754  400 

Gooseberries 

7,375 

Grapes,  canned 

61,000 

Grits 

1,320,000 

Ham ... 

1  113  774 

Lard  compound 

1,469,520 

Meal,  corn 

4,435,750 

Meal,  oat 

4  958,250 

Milk,  fresh 

13,553,782 

Milk,  condensed 

36,336 

Onions 

1,285,938 

Oysters 

10  050 

Peaches,  canned 

19,186 

Peaches,  dried 

567  000 

Pears,  canned 

43,344 

Pears,  dried 

572  250 

Peas,  canned 

263,550 

Pineapple 

95,974 

Plums,  canned 

88,875 

Pork,  fresh 

5,101,490 

Potatoes,  Irish 

5,560  160 

Potatoes,  sweet 

2,337,810 

Prunes 

899  775 

Pumpkins 

1,230,000 

Raisins 

809  025 

Rice 

2,704,700 

Sausage 

3  078  000 

Spaghetti 

988,200 

Squash 

562,380 

Sugar,  granulated •. . . 

8,525,800 

Sugar,  powdered 

46,350 

Sirup 

6,732,640 

Tomatoes,  canned 

88,992 

2,676,352 

Turnips 

286,440 

Wheat,  cracked 

328,200 

Yeast 

30,500 

Totals 

220,990.00 

10,910.08 

11,030.25 

49,019.43 

154,363,497 

Amount  per  day  per  capita 

4.17 

86  grams 

90  grams 

426  grams 

2,920 

Topeka  State  Hospital. 


39 


TOPEKA  STATE  HOSPITAL. 
TABLE  B. — Summaries  of  dietaries  for  twelve  months. — Per  capita  use  of  food. 


Dietaries. 

Weight 
of  food, 
pounds. 

Proteins, 
grams. 

Fat, 
grams. 

Carbo- 
hydrates, 
grams. 

Calories. 

Cost 

1917. 
October         

4.22 
3.32 
3.54 

2.63 
3.09 
2.85 
3.36 
3.23 
3.11 
3.33 
3.95 
4.17 

86 
84 
90 

90 
90 
86 
93 
86 
86 
92 
82 
86 

93 
104 
99 

77 
122 
95 
95 
86 
136 
77 
82 
90 

444 
312 
430 

403 
399 
408 
456 
421 
399 
449 
376 
426 

3.197 
2,500 
3,043 

2,777 
3,109 
•       2,865 
3,156 
2,879 
3,194 
2,888 
2,596 
2,920 

$0,213 

.192 

December 

.226 

1918. 

.213 

February 

.235 

March 

.230 

April 

.228 

May 

.257 

June 

.257 

July 

.244 

August.  . .         

.257 

.278 

Average 

3.40 

87 

96 

410 

2,927 

?0.236 

The  column  marked  "Calories,"  in  table  B,  is  of  great  interest,  because 
this  shows  the  total  energy  consumed,  and  the  different  months  are 
strictly  comparable.  There  is  considerable  variation  in  this  table  from 
a  minimum  of  2,500  pounds  in  November,  1917,  to  a  maximum  of  3,197 
pounds  in  October,  1917. 

The  best  information  in  regard  to  the  number  of  calories  per  capita 
needed  seems  to  point  to  the  fact  that  something  between  3,000  and  3,500 
calories  of  food  are  needed  for  a  man  occupied  with  ordinary  work.  It  is 
true,  however,  that  the  inmates  of  this  institution  would  hardly  come 
under  this  class,  so  that  it  is  quite  right  to  consider  that  this  figure  might 
with  safety  be  appropriately  reduced. 

Some  interesting  data  may  be  obtained  from  the  total  calories  for  the 
twelve  months,  which  is  1,857,673,110.  This  represents  the  total  food 
served  during  the  year,  and  if  we  divide  the  total  cost  for  the  year  by  this 
figure  and  multiply  by  1,000  it  ^ives  us  the  cost  of  energy  units  per 
thousand  calories.  This  is  .0812  cents.  This  is  valuable  for  comparison 
with  the  data  obtained  from  other  institutions,  although  with  the  growing 
cost  of  living  this  figure  will  sensibly  increase  from  year  to  year. 

It  will  be  noticed  that  the  weight  of  food  used  varies  from  2.63  pounds 
per  day  for  each  of  the  inmates  in  January,  1918,  to  4.22  pounds  per 
capita  in  October,  1917. 

There  is  also  shown  in  this  table  considerable  variation  in  fat,  which 
is  brought  out  more  especially  in  the  per  capita  calculation.  This  runs 
through  a  rather  large  range,  from  77  grams  in  January  and  also  through 
July,  to  136  grams  in  June. 

The  amount  of  carbohydrates  used  varies  between  312  grams  in  No- 
vember, 1917,  and  456  grams  in  April. 


40 


A  Dietary  Study. 


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Topeka  State  Hospital.  41 

Table  C  is  a  comparison  of  the  per  capita  use  of  some  of  the  important 
staples.  For  the  sake  of  easier  comparison  these  amounts  are  reduced 
to  ounces  per  capita  and  the  important  staples  selected  are  those  which 
represent  very  large  averages  of  the  food  value.  In  some  cases  it  is 
quite  possible  that  a  larger  amount  was  charged  to  the  kitchen  than  was 
actually  used,  and  so  some  of  it  was  held  over  in  the  kitchen.  That 
would  seem  to  be  indicated  by  the  low  amount  of  flour  in  November,  3.52 
ounces,  as  compared  with  the  average  of  the  twelve  months  of  8.04  ounces. 

The  amount  of  corn-meal  grits  used  varies  considerably,  but  as  the 
total  amount  was  comparatively  small,  that  is  not  of  much  importance. 
It  would  have  been  better,  perhaps,  not  to  have  used  so  much  in  June, 
July  and  August. 

In  regard  to  Irish  potatoes,  what  was  said  previously  in  regard  to 
issuing  flour  to  the  kitchen  may  also  apply  here,  as  a  very  large  quantity 
was  issued  in  December  and  a  very  small  amount  in  January;  probably 
this  should  be  distributed  between  the  two  months.  July  is  exceptionally 
low,  due,  probably,  to  the  scarcity  of  potatoes  during  that  month  and  the 
month  of  August.  Sweet  potatoes  are  only  issued  during  November  and 
December,  when  they  are  abundant  and  readily  obtainable. 

The  amount  of  granulated  sugar  is  1.44  ounces,  or  a  per  capita  con- 
sumption of  2.7  pounds  per  month.  The  allowance  which  was  made  dur- 
ing the  scarcity  of  sugar  by  the  government  was  an  amount  of  two 
pounds  per  capita  per  month,  and  it  is  interesting  to  note  that  the  amount 
used  here  is  not  very  much  above  that  recommended  by  the  Food 
Administration.  As  will  be  noticed  by  comparison  with  the  other  state 
institutions,  it  is  not  as  much  as  was  used  in  some  of  the  others.  The 
sirup  may  be  made  to  take  the  place,  to  a  certain  extent,  of  the  sugar, 
and  there  was  a  notable  increase  in  the  amount  of  sirup  used  during  the 
spring  months.  Of  course,  if  we  consider  sirup  and  sugar  together,  the 
amount  of  saccharine  material  used  is  considerably  larger  than  the  Food 
Administration  had  recommended. 

In  regard  to  beef,  the  quantity  is  quite  uniform  throughout  the  year, 
with  an  average  of  5.35  ounces  per  day.  The  same  thing  in  regard  to 
uniformity  may  be  said  of  pork,  which  shows  an  average  of  .66  per  day. 

Considering  the  lard  and  lard  compound,  which  comes  under  the  head 
of  fat,  the  same  discrepancy  is  again  noticed  for  the  month  of  June  as  is 
referred  to  in  a  previous  table,  but  as  there  seems  to  be  none  mentioned 
in  July  or  August,  no  doubt  the  amount  issued  in  June  was  used  during 
the  following  moAths. 

The  average  amount  of  milk  used  per  day  is  12.34  ounces,  or  about 
three-fourths  of  a  pint.  It  is  always  well  to  increase  the  quantity  of  milk 
to  the  highest  amount  possible.  The  same  thing  may  be  said  of  fruits. 
For  the  health  of  the  patients  as  large  a  quantity  of  fruits  should  be  used 
as  can  be  furnished  without  additional  expense. 


42 


A  Dietary  Study. 


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Topeka  State  Hospital.  43 

The  classification  of  groups  of  foods  used  and  per  cent  of  calories  is 
shown  in  table  D.  These  figures  are  obtained  by  comparison  of  the  total 
calories  of  the  food  with  the  calories  contained  in  each  one  of  these  groups 
of  foodstuffs.  Referring  to  the  column  marked  "Average,"  it  will  be 
noticed  that  more  than  one-third  of  the  calories,  namely,  37.99  per  cent, 
are  obtained  from  the  breadstuff s ;  and  next  in  order,  18.49  per  cent  from 
meats,  fish,  etc.,  while  sugar  and  sirup  follow  with  11.21  per  cent,  and 
milk,  cheese  and  eggs  with  10.15  per  cent.  Thus  it  will  be  seen  that  these 
four  classes  of  staples  furnish  77.84  per  cent  of  the  calories,  or  more 
than  three-fourths. 

An  attempt  should  be  made  to  increase  the  amount  of  vegetables  and 
fruits  during  the  portion  of  the  year  in  which  these  are  abundant.  Com- 
paring the  quantity  of  vegetables  used  in  each  month,  it  will  be  seen  that 
to  a  certain  extent  this  has  been  done.  The  cost  per  day  is  shown  in 
table  B.  The  total  population  was  very  uniform  for  the  year,  with  an 
average  of  1,747.4.  There  seems  to  be  little  relation  between  the  cost 
per  month  and  the  total  attendance.  This  probably  could  not  be  ex- 
pected, however,  when  food  is  carried  over  from  month  to  month. 

The  cost  per  day  per  capita  is  interesting,  as  it  shows  a  gradual  in- 
crease from  19.2  cents  to  27.8  cents  in  September,  following  the  rise  in  the 
prices  of  foodstuffs  on  the  market.  No  doubt  a  comparison  made  during 
the  current  year  would  show  still  greater  increase.  The  average  for  the 
year  was  23.6  cents,  which  is  certainly  as  low  as  could  be  expected,  con- 
sidering the  cost  of  foods. 

SUMMARY  AND  REMARKS. 

The  dietary  for  an  entire  year  has  been  studied  so  that  any  inaccu- 
racies of  any  particular  month  may  be  equalized  in  the  average. 

1.  If  great  care  is  used  in  issuing  supplies  to  the  kitchen,  so  that 
what  is  issued  is  actually  consumed  during  the  given  month,  it  will 
make  it  much  easier  to  make  comparisons. 

2.  It  would  be  well  to  so  regulate  the  diet  that  more  food,  and  es- 
pecially more  fatty  food,  should  be  used  in  the  winter  months  than  in  the 
summer.  The  report  of  the  steward  does  not  show  this  to  have  been  the 
case. 

3.  A  more  careful  study  of  the  character  of  the  individuals  would  be 
necessary  to  decide  what  amount  of  calories  per  capita  per  day  would 
be  sufficient,  but,  all  things  considered,  it  is  probable  that  the  amount  in 
this  institution  might  be  somewhat  diminished  without  impairment  of 
the  physical  health. 

4.  -Although  potatoes  contain  less  than  22  per  cent  of  nutritive  ma- 
terial, and  even  if  somewhat  expensive  as  compared  with  former  years, 
on  account  of  their  dietetic  value,  and  because  they  can  be  prepared  in 
such  a  variety  of  ways  to  stimulate  the  appetite,  the  quantity  of  potatoes 
used  should  be  kept  as  high  as  possible. 

5.  The  amount  of  corn  meal  used  might  be  increased  during  the  winter 
months  and  decreased  in  the  summer.  A  large  amount  of  corn  products 
should  be  used,  on  the  score  of  cheapness,  but  care  must  be  exercised 


44        •  A  Dietary  Study. 

not  to  push  their  use  to  a  point  where  the  appetite  becomes  surfeited 
with  them,  for  in  many  respects  wheat  products  are  better  food. 

6.  On  account  of  the  high  price  of  sugar,  it  is  advisable  to  keep  this 
down  to  2.5  pounds  per  month  per  capita.  If  more  saccharine  material 
seems  to  be  desired  it  can  be  made  up  by  the  use  of  sirup. 

7.  Increase  the  quantity  of  milk  as  much  as  possible,  for  according  to 
the  latest  theories  of  dietitians  there  is  no  food  that  will  tend  to  improve 
the  health  of  the  patients  more  than  an  abundance  of  milk.  Very  few 
realize  that  the  cost  of  milk  per  100  calories  is  usually  only  one-half  the 
cost  of  beef.  As  an  illustration,  it  was  found  in  New  York  City,  on 
January  1, 1919,  that  1,000  calories  of  energy  cost  as  milk  24  cents,  and  as 
beef  45  cents. 

8.  It  goes  without  saying  that  the  more  vegetables  that  can  be  used 
the  better  for  the  quality  of  the  dietary.  As  a  well-known  author  says, 
"Scurvy  appears  when  the  diet  contains  no  antiscorbutic  vitamines,  i.  e., 
by  using  diets  which  are  free  from  fruits,  fresh  vegetables,  and  tubers 
such  as  potatoes." 

9.  The  management  is  to  be  commended  for  keeping  the  cost  of  the 
food  low.  The  gradual  increase  from  19.2  cents  to  27.8  cents  is  no  more 
than  could  be  expected  with  the  general  increase  of  the  cost  of  living. 

It  is  hoped  that  this  data  and  the  suggestions  made  from  the  study 
of  the  food  in  actual  use  at  this  institution  may  be  of  value  in  increasing 
the  efficiency  of  the  management  and  keeping  the  cost  of  the  food  as  low 
as  possible,  considering  at  the  same  time  the  health  of  the  patients. 


VI. 

STATE  HOSPITAL  FOR  EPILEPTICS,  PARSONS. 

(Abstract  of  Report.) 


Lawrence;  Kan.,  May  17,  1920. 

The  examination  of  the  dietary  of  the  Parsons  State  Hospital  was 
undertaken  with  the  object  of  ascertaining  whether  the  quantity  of  food 
used  is  sufficient  for  the  inmates;  is  the  quality  satisfactory?  are  the 
different  nutritives  so  distributed  that  there  is  a  sufficient  proportional 
quantity  of  carbohydrates,  fats  and  proteins  for  complete  nourishment? 
whether  it  is  possible  to  substitute  cheaper  foods  for  those  issued  and 
still  keep  up  the  proper  dietary;  could  any  other  foods  or  a  greater 
variety  be  added  to  the  menu  with  advantage  to  the  inmates?  is  there 
any  unnecessary  waste  in  preparing,  dispensing  or  serving  the  food? 
are  all  the  waste  products  utilized  as  far  as  possible  by  feeding  to  ani- 
mals and  in  similar  ways?  can  the  cost  be  decreased  without  loss  of 
food  value  or  satisfactory  service? 

With  these  objects  in  view  the  steward  has  been  asked  to  furnish  the 
quantity  of  each  kind  of  food  issued  per  month,  and  this  investigation 
has  been  carried  through  from  October  1,  1918,  to  September  31,  1919, 
thus  covering  an  entire  year  and  including  both  the  winter  and  summer 
dietaries. 

The  results  given  in  table  A  have  been  compiled  from  the  steward's 
report,  and  the  following  tables  contain  a  discussion  of  the  results,  with 
suggestions  in  regard  to  any  possible  improvements  that  might  be  made. 

In  order  to  eliminate  from  this  abstract  most  of  the  details  of  the 
work,  the  tabulation  for  the  month  of  September,  1919,  only,  is  given. 

In  table  A  is  shown  the  weight  in  pounds,  the  protein,  fats  and  carbo- 
hydrates in  pounds,  and  the  calories.  A  glance  at  the  column  headed 
"calories"  shows  where  most  of  the  energy  of  the  food  comes  from,  the 
highest  numbers  being  bread,  beef,  butterine,  beans,  flour,  lard,  corn 
meal,  milk,  potatoes,  rice  and  sirup. 

That  there  is  a  variety  in  the  food  may  be  inferred  from  the  list  of 
food  materials  given  in  the  left-hand  column.  These  for  each  month  are 
as  follows: 


Month.  Varieties. 

October 59 

November   53 

December 49 

January 53 

February 55 

March    53 


Month. 

April  . 
May  . . 
June  .. 
July 


Varieties. 

61 

....   60 

52 

....  48 


August 55 

September 52 


(45) 


46 


A  Dietary  Study. 


STATE  HOSPITAL  FOR  EPILEPTICS. 
TABLE  A.— Dietary  for  September,  1919. 


Articles  of  Food. 


Apples 

Apple  butter 

Apricots 

Apricots,  dried 

Bacon 

Beans,  green 

Beans,  Lima 

Beans,  navy 

Beans,  Mexican 

Beef 

Bread 

Breakfast  food 

Butterine 

Cabbage 

Carrots 

Cherries 

Corn 

Crackers,  soda 

Cucumbers 

Eggs 

Figs 

Fish 

Flour,  white 

Gooseberries 

Grapes 

Grits 

Hominy 

Lard 

Lemons 

Macaroni 

Meal,  corn 

Milk 

Onions 

Oysters 

Peaches 

Peanut  butter 

Pears. 

Pears,  dried 

Peas 

Peas,  split 

Plums 

Potatoes,  Irish 

Potatoes,  sweet 

Pumpkin 

Pudding 

Rice 

Salmon 

Spaghetti 

Sugar •. 

Sirup 

Tomatoes,  canned 

Tomatoes 

Totals 

Amount  per  day  per  capita 


Weight, 
pounds. 


144 
180 
168 
200 
234 
861 
425 
800 
600 

7,824 

10,952 

108 

1,020 
600 
700 
120 

1,170 
266 
600 
270 
50 
660 

2,500 
150 
224 
200 
192 

1,000 

40 

220 

600 

31,100 

627 

30 

225 

50 

90 

250 

1,080 
180 
378 

7,920 
700 
48 


120 
70 
2,500 
2,320 
2,050 
2,072 


85,895 


Protein, 
pounds. 


2.16 

3.19 

9.73 

22.23 

18.08 

76.92 

180.00 

131.40 

1,134.48 

1,018.53 

5.94 

12.24 

8.40 

6.30 

1.32 

32.76 

26.06 

4.20 

32.13 

2.15 

76.56 

280.00 

1.95 

2.24 

23.00 

4.20 


.28 

29.48 

55.20 

1,026.33 

8.77 

2.64 

1.57 

14.75 

.27 

7.00 

38.88 

44.28 

3.78 

142.56 

9.80 

.38 

6.60 

6.40 

23.10 

8.47 


24.60 
18.64 


Fat, 
pounds. 


1.14 

.18 

2.18 

2.00 

138.99 

2.58 

6.37 

14.40 

7.80 

1,314.43 

131.42 

1.62 

846.60 

1.20 

1.40 

.12 

14.04 

24.20 

1.20 

25.11 

.15 

109.56 

25.00 

2.25 

2.92 

16.80 

.36 

1,000.00 

.20 

1.98 

1   ,4 

1,244.04 

1.88 

.72 

.22 

23.25 

.27 

13.50 

2.16 

1.80 


7.92 
4.20 

.09 
5.76 
2.40 
9.00 

.28 


4.10 
8.28 


5,037.55 


118  grams 


Carbo- 
hydrates, 
pounds. 


53.56 
105.30 

81.98 
125.00 


59.41 
280.07 
476.80 


6,771.70 
87.48 


28.80 
51.80 
25.32 
222.30 
194.44 
15.60 


37.10 


,872.50 
28.65 
35.13 

144.60 
34.16 


2.36 

163.02 

452.40 

1,555.05 

55.80 

1.17 

24.30 

8.55 

16.20 

182.25 

105.84 

111.60 

75.96 

1,164.24 

153.30 

3.21 

33.00 

632.00 


53.41 

2,500.00 

1,767.60 

82.00 

80.80 


19,349.64 


458  grams 


Calories. 


105,120 

200,700 

168,000 

252,000 

507,698 

151,536 

674,050 

1,251,200 

1,005,000 

7,667,520 

12,857,698 

176,148 

3.478,200 

72,600 

111,300 

28,840 

520,650 

498,750 

40,800 

160,650 

71,850 

575,080 

4,007,500 

67,500 

80,032 

383,000 

72,960 

4,082,000 

5,600 

357,280 

1,027,800 

9,765,714 

124,773 

10,050 

47,925 

137,050 

30,960 

408,750 

271,081 

290,160 

114,774 

2,407,680 

312,900 

7,200 

97,812 

1,272,800 

79,200 

113,400 

4,535,000 

3,366,320 

211,150 

213,416 


64,585,125 


3,381 


State  Hospital  for  Epileptics, 


47 


STATE  HOSPITAL  FOR  EPILEPTICS. 
TABLE  B.— Summaries  of  dietaries  for  twelve  months. — Per  capita  use  of  food. 


Dietaries. 

Weight 
of  food, 
pounds. 

Protein, 
grains. 

Fat. 
grains. 

Carbo- 
hydrates, 
grams. 

Calories. 

Cost 

per  day 

per  capita. 

1918. 
October 

4.31 
3.99 
4.20 

4.03 
4.16 
4.20 
5.21 
5.08 
5.82 
5.70 
5.26 
4.49 

99.0 
90.0 
95.0 

99.0 

104.0 

9.0 

118.0 

95.0 
109.0 
104.0 

95.0 
109.0 

113.0 
117.0 
72.0 

122.0 
104  0 
104.0 
127.0 
109.0 
108.0 
113.0 
109.0 
118.0 

508 
435 
512 

499 
462 
449 
544 
499 
463 
472 
472 
458 

3,474 
3,199 
3,076 

3,545 

3,191 
3,847 
3,407 
3,310 
3,312 
3,284 
3,381 

$0.34 

November                   .... 

.31 

.31 

1919. 

.29 

February                    

.32 

March 

.31 

Anril                        

.38 

May 

.37 

June                       

.34 

July 

.32 

August                       

.35 

.32 

Average 

4.70 

100.5 

109.6 

481 

3,355 

$0.33 

The  minimum  "attendance"  for  the  year  was  17,508  for  February  and  the  maximum  was  19,719  for  May. 
Average  for  the  twelve  months,  628.5. 


Table  B  gives  an  opportunity  to  look  at  the  dietary  of  the  institution 
for  the  entire  year.  The  protein  or  nitrogenous  foods  (such  as  meat, 
milk,  eggs,  etc.)  are  the  most  expensive,  and  there  is  this  remarkable 
fact  shown  in  the  table,  although  it  may  be  only  a  coincidence:  In  No- 
vember the  weight  of  protein  purchased  was  3,723.21  pounds,  the  smallest 
of  any  month,  and  the  same  month  was  one  of  the  lowest  in  per  capita 
cost.  A  similar  comparison  for  the  highest  protein  named,  that  for  April, 
shows  that  the  cost  per  capita  for  this  month  was  the  greatest  of  any 
month.  Considering  this  table  further,  under  the  head  of  "Calories  per 
capita"  (one  of  the  fairest  methods  of  comparison  of  the  several  months), 
it  is  noticed  that  these  vary  from  3,096  in  December  to  3,847  in  April. 
Here  again  April  shows  a  higher  feeding  than  any  of  the  other  months. 
From  what  we  know  of  calorie  requirements,  the  amount  of  food  issued 
in  even  the  lowest  months  is  sufficient  for  the  wants  of  the  inmates.  An 
adult  doing  a  fair  amount  of  work  each  day  expends  not  more  than  3,300 
to  3,500  calories,  and  these  inmates  at  this  institution  are  quite  a  distance 
below  the  normal  man  in  physical  activities.  The  average  of  3,355  should 
keep  the  patients  in  good  condition  and  leave  a  margin  to  build  up  the 
body  and  add  to  their  feeling  of  well-being. 

The  weight  of  food  here  shown  is  interesting.  In  considering  this  it  is 
well  to  remember  that  some  of  the  food,  as  fats,  sugar,  etc.,  are  very 
concentrated  nourishment,  while  the  meats  and  cereals  contain  50  to  75 
per  cent  of  water  and  the  vegetables  contain  from  70  to  95  per  cent  of 
water.-  The  four  to  six  pounds  of  food  issued  is,  therefore,  not  all 
nutritive  materials,  as  fruit  and  vegetables  contain  so  much  water,  and 
these  are  more  extensively  used  in  the  summer.  Other  things  being 
equal,  the  food  supplied  during  the  summer  should  be  greater  in  weight 
to  give  the  same  amount  of  energy.  Notice  that  the  six  months  from 
April  to  September  are  all  higher  than  the  other  half  of  the  year.  As 
to  the  amount  of  food  needed,  50  to  60  ounces  is  usually  considered 


48 


A  Dietary  Study. 


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state  Hospital  for  Epileptics,  49 

enough.     Amounts  here  vary  from  64  to  93  ounces,  which  is  certainly 
ample. 

Comparing  the  different  months,  three  seems  to  be  little  relation 
between  the  cost  and  the  attendance.  The  per  capita  cost  per  day  is  low, 
considering  the  increasing  cost  of  living  during  the  year.  As  previously 
noted,  the  month  of  April,  when  the  protein  was  highest,  shows  the  great- 
est per  capita  cost  for  food. 

Table  C  shows  the  amount  per  day  of  some  of  the  most  important 
foods  used  by  each  person  in  each  month,  and,  for  convenience,  is  calcu- 
lated to  ounces.  The  average  quantity  of  flour  is  1.58  ounces;  of  pota- 
toes, 8.57  ounces.  This  is  rather  low  during  the  months  of  May,  July  and 
August,  when  potatoes  were  perhaps  scarce.  Even  at  prevailing  prices, 
the  amount  of  potatoes  used  should  always  be  as  high  as  the  dietary  will 
stand. 

The  sugar  used  was  4.4  pounds  per  month,  and  this  is  supplemented 
by  3.5  pounds  of  sugar  in  sirup  used,  making  a  total  of  7.9  pounds  of 
saccharine  substances.  During  the  period  when  sugar  was  very  scarce, 
the  Food  Administration  allowed  two  pounds  per  month  per  capita,  so 
the  amount  of  sugar  used  here  is  much  larger  than  is  positively  neces- 
sary. Whether  it  can  be  reduced,  considering  the  abnormally  high  price 
of  sugar  this  year,  and  thus  decrease  the  cost  of  food,  is  for  the  authori- 
ties of  this  institution  to  consider. 

Beef  is  always  an  expensive  item,  but  an  excellent  source  of  protein 
and  fat.  Over  one-fourth  pounds  per  day  per  person  seems  to  be  an 
abundance,  and  possibly  some  might  be  replaced  by  beans  and  protein- 
yielding  food.  The  meat  used  here,  however,  is  not  as  much  as  at  some  of 
the  other  state  institutions. 

From  18  to  31  ounces  of  milk  for  each  of  the  inmates,  or  an  average  of 
a  little  less  than  a  quart,  is  a  gopd  showing.  This  is  one  of  the  most 
valuable  foods  that  can  be  used  in  this  institution,  and  the  quantity 
should  be  kept  at  as  high  a  figure  as  possible. 

If  some  arrangement  could  be  made  so  that  even  more  fish  could  be 
used,  it  would  lower  the  cost  and  increase  the  variety  of  foods.  The 
fish  should  be  fresh  if  possible,  but  if  not,  either  salted  or  dried. 

Table  D  shows  the  source  of  the  energy  derived.  Of  the  total  calories 
nearly  one-third  comes  from  breadstuffs,  and  next  in  abundance  is  that 
from  milk,  cheese  and  eggs.  This  is  satisfactory,  for  it  is  not  advisable 
in  this  institution  to  depend  too  largely  on  meat  for  the  protein  and  fat. 
More  than  one-seventh  of  the  energy  comes  from  the  sugar  and  sirup. 
There  is  always  a  tendency  to  use  large  quantities  of  sugar  because  of 
its  agreeable  taste.  The  amount  of  fruit  used  should  be  kept  as  high  as 
possible. 

In  comparing  the  different  state  institutions  so  far  studied,  the  Osa- 
watomie  and  Topeka  hospitals  are  the  only  ones  that  are  at  all  comparable 
with  the  Parsons  institution,  and  the  comparison  should  not  be  carried 
too  far  even  with  them.  The  amount  of  food  used  is  greater  at  Parsons, 
and  this  gives  a  higher  calorie  and  protein  value  per  capita.  Possibly  the 
character  of  the  inmates  in  Parsons  necessitates  this.  The  cost  is  also 
more,  but  these  figures  are  made  on  a  rising  food  market,  the  Parsons 
institution  being  the  latest  of  the  series  examined. 

4 — Dietary — 575 


50 


A  Dietary  Study, 


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state  Hospital  for  Epileptics,  51 

RECAPITULATION. 

1.  As  the  food  at  this  institution  is  prepared  in  the  kitchens  of  fif- 
teen or  more  different  cottages,  there  are  some  advantages  not  possessed 
by  those  institutions  where  the  food  is  all  prepared  in  one  or  two  kitchens. 

2.  An  examination  of  the  food  supplied  indicates  that  the  quality  is 
good.  In  a  few  cases  where  a  question  arose  as  to  the  quality,  samples 
were  taken  and  examined  at  the  State  Food  Laboratory  in  Lawrence. 
The  report  on  these  is  as  follows : 

Tomatoes:  Refraction  of  filtered  juice,  33.6;  acidity  as  lactic  acid, 
0.73;  appearance  of  content,  good. 

Catsup:  Appearance,  good;  no  artificial  color  or  preservatives  de- 
tected. 

Rice:  Appearance,  good;  glucose,  none  detected;  talc,  present.  This 
latter  ingredient  is  unnecessary,  but  is  often  used  to  improve  the  ap- 
pearance of  the  product. 

Vanilla  flavor:  No  adulteration  found. 

Prunes:  These  had  a  soured  or  moldy  odor,  and  on  examination 
showed  that  insects  were  present.  If  used  they  should  be  thoroughly 
washed  several  times  and  the  water  thrown  away. 

3.  The  necessary  waste  from  the  preparation  of  the  food  and  left- 
overs not  edible  is  fed  to  hogs,  and  the  hogs  are  sold,  so  that  it  is  probable 
that  a  much  smaller  actual  waste  occurs  here  than  in  the  ordinary  city 
household. 

4.  The  food  given  out  by  the  storekeeper  is  used  for  the  patients,  ad- 
ministrative force  and  helpers,  and  as  the  latter  force  is  large,  this  brings 
up  the  necessary  amount  of  food  above  what  it  would  be  if  patients  alone 
were  fed. 

5.  Farm  products  are  used  as  much  as  possible.  This  not  only  dimin- 
ishes the  cost,  but  it  affords  a  greater  variety  of  food. 

6.  The  examination  of  the  dietary  indicates  that  one  practical  method 
for  reducing  expenses  is  to  decrease  the  protein,  especially  that  from 
meat. 

7.  The  energy  of  the  food,  as  shown  by  the  calories  per  capita,  is 
sufficiently  high  for  an  institution  of  this  class.  In  fact,  the  amount  of 
food  might  be   slightly  decreased  without  any  injury  to  the  patients. 

8.  Although  the  weight  of  the  food  served  is  greater  in  the  sum- 
mer months,  there  is  no  increase  in  calories  at  that  time — a  condition 
which  is  satisfactory. 

9.  If  the  amount  of  sugar  and  saccharine  substance  can  be  reduced 
during  the  present  high  price  of  sugar,  it  should  be  done,  and  the  patients 
will  not  suffer.  It  may  be  possible  to  substitute  sorghum  for  some  of 
the  sirup  in  the  fall. 

10.  The  amount  of  milk  used  is  to  be  commended.  It  should  be  kept 
as  high  as  possible. 

11.  That  the  institution  has  been  able  to  use  so  much  fish  to  replace  a 
part  of  the  meat  is  to  be  commended.  Most  fish  is  readily  digested  and 
adds  variety  to  the  diet. 

12.  Table  D  shows  that  11.1  per  cent  of  the  total  calories  comes  from 
meat  and  fish.  All  things  considered,  this  is  sufficiently  high  and  would 
allow  a  small  decrease  without  injury  to  the  diet. 


52  A  Dietary  Study, 

13.  The  cost  per  day  per  capita  did  not  rise  during  the  year,  but  this 
may  be  largely  due  to  the  purchase  of  most  of  the  food  by  contract.  If 
food  had  been  bought  on  the  open  market  a  gradual  increase  would  have 
probably  been  shown. 

14.  The  calories  and  the  cost  of  food  are  greater  at  the  Parsons  Hos- 
pital than  at  either  the  Osawatomie  or  the  Topeka  Hospital,  but  it  must 
be  remembered  in  comparing  cost  that  the  Parsons  institution  was 
studied  a  year  later  than  the  other  two  and  during  the  time  of  a  rising 
food  market. 

15.  In  the  comparison  of  tables  it  should  be  noted  that  the  bread  was 
purchased  at  the  Parsons  institution,  so  the  amount  of  flour  is  low.  The 
high  milk  and  low  pork  consumption  is  well  shown  here.  The  quality 
of  the  bread  used  in  the  Parsons  Hospital  might  be  improved.  The 
process  of  raising  is  carried  too  far,  thus  giving  a  larger  loaf  for  the 
amount  of  flour  used,  but  producing  slight  acidity  in  the  bread. 

16.  The  cost  for  1,000  calories  represents  the  actual  cost  of  energy 
supplied  by  the  food.  The  increase  of  the  Parsons  institution  over  the 
other  two  hospitals  can  be  accounted  for  by  the  later  date  of  this  in- 
vestigation. 


VIL 

STATE  SCHOOL  FOR  THE  BLIND,  KANSAS  CITY., 

(Abstract  of  Report.) 


Lawrence,  Kan.,  March  3,  1921. 

An  abstract  of  the  report  on  the  dietary  of  the  Kansas  State  School  for 
the  Blind,  at  Kansas  City,  Kan.,  is  herewith  submitted.  The  objects  of 
the  investigation  were  the  same  as  for  the  institutions  already  studied. 

With  these  objects  in  view,  the  steward  has  been  asked  to  furnish  the 
quantity  of  each  kind  of  food  issued  per  month,  and  this  investigation 
has  been  carried  through  from  January,  1919,  to  December  31,  1919,  thus 
covering  an  entire  year  and  including  both  the  winter  and  summer 
dietary. 

In  this  abstract  the  report  for  the  month  of  October,  1919,  only  is 
given,  and  is  designated  as  table  A. 

The  results  given  in  table  A  have  been  compiled  from  the  steward's 
report,  and  remarks  follow  each  at  the  end,  and  there  is  a  discussion  of 
the  results,  with  suggestions  as  to  any  possible  improvements  that  might 
be  made. 

As  in  most  of  these  institutions,  the  steward  issues  the  needed  foods 
daily  to  the  different  kitchens  (at  the  Penitentiary  there  are  four),  an 
accurate  account  is  kept  of  the  daily  population,  or  those  who  use  this 
food,  and  from  this  data,  at  the  end  of  the  month,  we  have  what  the  in- 
mates have  lived  on  for  that  month.  The  waste  from  most  of  these  kitch- 
ens is  fed  to  chickens  or  hogs,  so  that  the  actual  loss  of  food  material  is 
small.  The  fruits,  vegetables,  etc.,  raised  on  the  institution  farm  are 
accounted  for  and  issued  to  the  inmates  ag  if  purchased  at  the  market 
price.  This  practice,  of  course,  greatly  lowers  the  actual  cost  to  the 
state  of  keeping  the  inmates  of  these  institutions. 

It  will  be  noted  that  from  the  steward's  report  for  each  month  the 
actual  weight  of  the  food  as  given  out  is  stated;  then  from  the  standard 
table  of  food  values  the  protein,  fat  and  carbohydrates  is  calculated ;  and 
in  the  last  column  the  calories  or  energy  value  of  that  amount  of  food. 
Thus,  24  gallons  of  apple  butter,  weighing  240  pounds,  yields  only  2.88 
pounds  of  protein  and  0.24  pounds  of  fat;  but  its  value  is  mostly  in  the 
140.40  pounds  of  carbohydrates,  and  the  whole  yields  267,600  calories; 
this  is  its  energy  value. 

(53) 


54 


A  Dietary  Study, 


STATE  SCHOOL  FOR  THE  BLIND. 
TABLE  A.— Dietary  for  Octoter,  1919. 


Articles  of  Food. 

Weight, 
pounds. 

Protein, 
pounds. 

Fat, 
pounds. 

Carbo- 
hydrates, 
pounds. 

Calories. 

Apples,  fresh      

3,447.00 

126.00 

10.00 

400.00 

216.00 

90.00 

95.00 

356.00 

620.00 

60.00 

180.00 

10.00 

24.00 

1,600.00 

159.00 

150.00 

100.00 

4,539.00 

144.00 

30.00 

50.00 

3,005.00 

60.00 

90.00 

752.00 

45.00 

27.00 

100.00 

100.00 

500.00 

120.00 

25.00 

125.00 

820.00 

295.00 

40.00 

10.34 
1.13 

10.34 

342.27 

21.79 

3.00 

19.20 

174.96 

59.31 

61.84 

260.23 

29.76 

12.66 

34.20 

.45 

.62 

1,198.40 

737  658 

42,840 

Baking  powder 

5,440 

Buttermilk 

12.00 

11.88 

16.29 

20.80 

34.88 

8.68 

.66 

5.04 

.25 

.21 

179.20 

27.82 

2.00 

3.24 

1.35 

1.23 

32.39 

1.24 

.06 

2,16 

1.85 

.02 

16.00 

29.31 

150.00 

1.90 

181.56 

51.51 

.27 

.15 

3.00 

.12 

.26 

4.51 

.18 

21.27 

64,800 

Breakfast  food 

352,296 

142,740 

Bean  ■■,  pinto 

159,125 

667,500 

Cabbage 

74,772 

24,420 

Corn     

80, 100 

Cream 

8,810 

Celery 

1,632 

Flour 

2  564  800 

Ham 

170,607 

Lard 

612  300 

9.20 

149.78 

42.48 

4.02 

.70 

54.09 

.  2.16 

.26 

10.52 

.22 

1.59 

1.80 

4.70 

75.40 

226.95 

64.38 

22.23 

4.45 

441.73 

5.88 

16.20 

164.68 

5.71 

161,300 

Milk,  fresh                                       ..    . 

1,425,246 

404,352 

Macaroni 

48,720 

9,950 

Potatoes,  Irish. . .       .            ... 

913,520 

Peas 

15,060 

Pears                              

30,960 

336,144 

Pears,  fresh 

11,520 

Pork,  salt 

92, 745 

Prunes. 

62.20 

62.50 

500.00 

116,100 

Peaches  dried 

1.00 

126,000 

Sugar 

907,000 

Salmon 

23.40 
5.20 
15.25 

9.00 

.25 

55.00 

79,200 

1.05 

1.37 

660.10 

11.80 

35.20 

12,450 

256,500 

1,189,820 

3.50 
.16 

.55 
.04 

30,385 

Tapioca 

64,320 

Totals 

18,510.00 

659.21 

581.76 

4,610.52 

11,941,132 

Amount  per  day  per  capita 

4.42 

71  erams 

63  grams 

499  grams 

2,853 

The  first  thing  that  the  inspection  of  this  dietary  suggests  is  its  many- 
irregularities,  as  shown  by  a  comparison  of  the  food  of  different  months. 
As  will  be  seen  later,  this  is  probably  more  apparent  than  real,  but  it  is 
very  forcibly  brought  out  in  the  summaries.  For  instance,  the  pounds  of 
food  per  day  for  each  of  the  pupils  seems  to  be  as  follows  for  the  twelve 
months:  2.6,  8.88,  2.58,  2.21,  1.76,  4.31,  2.52,  3.53,  2.74,  4.42,  6.64  and 
2.44.  That  this  should  be  true  is  absurd,  but  a  glance  at  the  individual 
months  shows  that  240  pounds  of  apple  butter  was  dispensed  in  January 
and  none  after  that;  469  pounds  of  beef  was  dispensed  in  September  and 
none  in  October.  The  potatoes  were  stored  in  October,  November  and 
February  and  only  small  quantities  at  other  times.  I  am  told  that  these 
irregularities  are  due  to  lack  of  storage  facilities,  but  they  certainly 
vitiate  any  attempt  to  arrive  at  the  actual  monthly  dietary,  and  make  it 
necessary  to  confine  our  conclusions  to  the  general  averages  of  the  year. 

The  wide  variation  as  shown  for  protein  in  table  B  is,  of  course,  in- 
correct, as  it  would  not  be  126  grams  in  February  and  only  42  per  capita 
in  May.  The  same  remark  applies  to  all  the  other  figures  in  this  table. 
Nor  would  the  calories  vary  from  1,630  per  capita  in  May  to  4,347  in 
February.     Although  there  are  very  few  pupils  in  the  summer  months, 


state  School  for  the  Blind. 


55 


STATE  SCHOOL  FOR  THE  BLIND. 
TABLE  B. — Suirmaries  of  dietaries  for  twelve  months. — Per  capita  use  of  food. 


Dietaries. 

Weight 
of  food, 
pounds. 

Protein, 
grams. 

Fat, 
grains. 

Carbo- 
hydrates, 
grams. 

Calories. 

Cost 

per  day 

per  capita. 

1919. 
January 

2.06 
8.88 
2.58 
2.21 
1.76 
4.31 
2.52 
3.53 
2.74 
4.42 
6.64 
2.44 

53 
126 
78 
61 
42 
106 
44 
77 
49 
71 
100 
58 

75 
95 
94 
82 
68 
115 
147 
81 
69 
63 
112 
103 

202 
739 
291 
223 
211 
612 
177 
470 
276 
499 
508 
198 

1,7  2 
4,347 
2,342 
1,892 
1,630 
3,813 
2,214 
2,871 
1,925 
2,853 
3,452 
1,962 

m  23 

.38 

March     

27 

.23 

May 

19 

.40 

July          

.57 

.65 

September 

.24 

October 

.28 

November 

.36 

.27 

Average 

3.67 

72 

92 

366 

2,668 

$0.38 

the  per  capita  consumption  of  food  should  only  be  a  little  higher  than 
during  the  rest  of  the  year. 

In  this  table,  however,  appear  the  average  of  the  different  nutrients 
for  the  entire  year.  The  average  age  of  the  girls  in  this  school  for  1920 
was  I4I/I2,  and  of  the  boys  13%i.  As  the  teachers  and  employees  were  also 
fed  from  this  supply,  this  would  raise  the  average  food  requirements 
somewhat.  It  is  evident  that  the  cost  per  day,  as  shown  in  this  table,  is 
of  no  value.  The  average  cost,  however,  for  the  year  of  38  cents  per  day 
for  each  of  the  inmates  is  perhaps  not  higher  than  would  be  expected  con- 
sidering the  rapidly  mounting  cost  of  living  during  this  year. 

Table  C  attempts  to  answer  the  question,  What  is  the  source  of  the 
energy  derived  from  the  food?  The  averages  in  the  last  column  are  the 
only  figures  to  be  considered,  and  it  will  be  noticed  that  although  bread- 
stuffs  furnish  the  largest  part  of  the  energy,  on  the  whole,  the  amounts 
are  fairly  distributed  between  the  seven  classes. 

How  many  ounces  of  each  class  of  food  did  the  inmates  use  daily? 
(Table  D.)  Potatoes  and  milk  constitute  the  largest  amount,  but  these 
both  contain  large  quantities  of  water,  while  such  foods  as  sugar  contain 
practically  no  water.  Flour  is  the  next  staple  in  quantity,  and  this  con- 
tains less  water  than  does  the  butter. 

What  is  the  source  of  the  protein  (the  material  that  builds  up  the 
tissues).  The  following  averages  for  the  year  were  obtained:  Vege- 
tables, fresh  and  dried,  12.64;  vegetables,  canned,  1.59;  cereals,  bread- 
stuffs,  26.10;  meat,  fresh,  17.34;  fish  and  canned  meat,  10.96;  milk,  con- 
densed, fresh,  and  buttermilk,  24.59;  fruits,  fresh,  dried,  canned,  2.72; 
butter,  oleo,  eggs,  cheese,  4.39.  Average  of  protein  from  animal  sources, 
57  per  cent;  from  vegetable  sources,  43  per  cent. 

RECAPITULATION. 

1.  With  reference  to  the  quality  of  the  ♦food  furnished,  it  seems  to  be 
excellent,  as  is  the  case  with  the  other  institutions  studied.  Although 
not  "extra  fancy,"  it  is,  as  a  rule,  good,  substantial  and  wholesome.  The 
following  samples,  which  it  was  though  might  be  unsatisfactory,  were 
examined  at  the  University  Food  Laboratory: 


56 


A  Dietary  Study. 


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state  School  for  the  Blind.  57 

A.  yamV^o— r"Fine  Flavoring  Extract."  This  was  found  to  contain 
37  per  cent  of  alcohol,  and  there  was  nothing  to  indicate  that  it  was  not 
of  good  quality. 

B.  Tomatoes,  complained  of  as  containing  some  "swells."  The  sample 
examined  was  normal  in  appearance,  taste  and  color.  It  contained  no 
added  water. 

C.  Loose  rrmscatel  raisins  were  found  to  contain  living  insects  and 
to  have  a  musty  odor.  Stems  and  disintegrated  fruit  were  present,  all 
of  which  indicated  inferiority. 

2.  At  the  end  of  each  monthly  table  is  a  summary  for  that  month. 
As  previously  stated,  the  method  of  issuing  supplies  to  the  kitchen  is 
not  satisfactory,  and  storage  facilities  should  be  such  that  an  accurate 
account  can  be  kept  of  what  food  is  issued  and  used,  at  least  for  the 
month,  if  not  daily. 

3.  The  wide  variation  in  calories,  protein,  fat  and  carbohydrates  is 
brought  out  very  clearly  in  table  B.  The  averages  on  the  lower  line 
are  the  only  figures  worthy  of  consideration.  It  will  be  noted  that  if  we 
consider  the  estimate  of  the  interallied  Scientific  Food  Commission 
(1918),  that  3,410  calories  per  day  is  sufficient  for  the  adult,  and  that 
growing  boys  and  girls  of  the  average  age  of  these  pupils  (13  to  14) 
need  83  per  cent  of  the  above;  that  would  require  2,830  calories.  The 
average  for  the  year  was  2,668.  This  appears  to  be  rather  low  when  we 
consider  the  fact  that  the  population  of  the  three  summer  months  was 
practically  all  adults,  and  these  would  need  more  food.  On  the  other 
hand,  it  was  learned  that  some  of  the  pupils  spend  the  week-end  at 
home,  which  would  increase  the  calorie  value  for  the  total  population. 

4.  The  average  protein  (72  grams),  as  shown  by  table  B,  appears  to 
be  somewhat  low  for  this  class  of  inmates,  10  per  cent  of  whom  were 
adults. 

5.  The  average  cost  of  living,  38  cents  per  day  per  capita,  is  not  higher 
than  would  be  expected  when  the  rapidly  increasing  cost  of  food  during 
this  period  is  considered.  It  was  higher  during  the  summer  months, 
when  adults  only  were  fed,  than  during  the  rest  of  the  year. 

6.  The  energy  derived  from  the  different  classes  of  foods,  as  shown  by 
table  C,  is  quite  well  distributed.  The  quantity  of  milk  used  should  be 
increased,  especially  for  growing  children.  This  was  about  a  pint  per  day 
for  each  of  the  inmates,  but  varied  greatly  during  the  different  months. 
One  thousand  calories  obtained  from  milk  usually  cost  only  half  as 
much  as  the  same  amount  of  energy  obtained  from  meat. 

7.  The  protein  from  animal  sources  was  57  per  cent  of  the  diet,  and 
that  from  vegetable  sources  43  per  cent.  It  is  well  to  increase  the 
vegetables  in  the  diet  as  much  as  possible. 

8.  On  account  of  the  proximity  of  the  Kansas  City  markets,  it  would 
seem  to  be  possible  to  substitute  fresh  fish  in  season  for  a  part  of  the 
meats. 


VIII. 

STATE  TRAINING  SCHOOL,  WINFIELD. 

Lawrence,  Kan.,  April  25,  1921. 

In  the  continuation  of  the  study  of  the  dietaries  of  the  state  institu- 
tions under  the  care  of  the  Board  we  have  taken  up  the  food  supply  of  the 
State  Training  School  at  Winfield.  As  collaborative  investigations  are 
being  made  by  another  department  on  this  institution,  we  have  confined 
our  study  to  the  limited  period  from  July  1,  1920,  to  December  31,  1920, 
without  a  special  study  of  each  month.  The  entire  food  supply  for  this 
half  year  is  therefore  considered.  This  supply,  calculated  to  weight, 
pounds  of  protein,  of  fat  and  of  carbohydrates,  and  in  the  terms  of 
calories,  is  stated  in  table  A. 

In  regard  to  the  weight  of  different  foods  as  shown  by  table  A,  column 
1,  the  largest  quantities  used  are  as  follows: 

Weight  Per  cent  of 

pounds.  water.  Calories. 

Fresh   milk 236,102  87  74,136,028 

White    flour    81,707  12  130,976,321 

Irish    potatoes     27,630  18  8,399,520 

Fresh    beef    19,716  50  19,321,680 

Tomatoes    (canned)    16,697  94  1,719,791 

Corn    (canned)     13,696  23  6,094,720 

Tomatoes    (fresh)     11,911  94  1,226,833 

Sugar     10,000  10  18,140,000 

Corn    (fresh)    9,882  90  1,758,996 

In  the  first  column  these  foods  are  arranged  in  the  order  of  their 
weights;  but  on  account  of  the  vastly  different  water  content,  the  per 
cent  of  which  is  shown  in  the  second  column,  the  arrangement  of  their 
food  value,  as  shown  by  the  calories  in  the  last  column,  is  very  different. 

This  table  also  shows  that  the  per  capita  amount  of  protein  per  day 
is  96.49  grams,  which  seems  to  be  satisfactory,  as  it  is  not  very  much  be- 
low what  would  be  required  for  adults  in  good  health  engaged  in  ordinary 
work. 

The  calories  per  day  per  capita,  3,188,  is  a  little  less  than  the  average 
amount  required  for  adults  ordinarily  employed  (3,300  to  3,500),  but  it 
seems  to  be  ample  considering  the  physical  condition  and  exercise  of 
those  who  are  fed  from  this  diet. 

The  cost  per  day  per  capita  ($0.29)  seems  to  be  very  reasonable,  con- 
sidering the  cost  of  living  during  the  period  studied. 

(58) 


state  Training  School. 


59 


STATE  TRAINING  SCHOOL. 
TABLE  A— Dietary  frcm  July  1,  1920,  to  December  31,  1920. 


Articles  of  Food. 


Apples,  canned 

Apples,  dt'ied 

Apple  butter 

Apples,  fresh 

Apricots,  canned.  .  . . 

Apricots,  dried 

Bacon 

Baking  powder 

Beans,  Lima 

Beans,  Mexican 

Beans,  string,  canned 

Beans,  string 

Beets 

Beans,  navy 

Beef,  fresh 

Blackberries 

Bread 

Cabbage 

Carrots 

Cantaloupes 

Catsup .^ 

Celery .' 

Cherries,  canned .... 

Cheese 

Chocolate 

Chowchow 

Corn 

Corn,  fresh 

Corn  meal 

Cucumbers 

Cornstarch 

Crackers,  cream 

Crackers,  Graham. . . 

Crackers,  soda 

Corn  flakes 

Cranberries 

Currants 

Candy 

Cabbage 

Chickens,  dressed. . . 

Eggs 

Fish 

Figs 

Flour,  white 

Flour,  Graham 

Gooseberries,  canned. 

Grapes,  canned 

Grapenuts 

Ham 

Hominy 

Kraut 

Liver 

Lemons 

Lemon  pudding 

Life  of  Wheat 

Macaroni 

Mackerel 

Melons,  water 

Milk,  fresh 

Milk,  condensed 

Nuts 

Onions 

Oatmeal 

Oranges 

Oleomargarine 

Oysters,  canned 

Peaches,  canned 

Peaches,  dried 

Peas,  canned 

Peas,  dried 

Pears,  fresh 


Weight, 
pounds. 


1,740.00 

4,950.00 

120.00 

2,220.00 

672.00 

500.00 

458.50 

200.00 

3,580,00 

2,800.00 

4,830.00 

2,568.00 

780.00 

6,300.00 

19,716.00 

420.00 

600.00 

4,975.00 

456.00 

720.00 

99.00 

300.00 

240.00 

1,025.00 

12.00 

53.00 

13,696.00 

9,882.00 

505,00 

2,049,00 

1,248,00 

308,00 

352,00 

2,000,00 

72,00 

200,00 

1,00 

370,00 

2,646.00 

122.00 

522.00 

540.00 

650.00 

81,707.00 

1,000.00 

128.00 

288,00 

36.00 

644,00 

6,480,00 

360,00 

51,00 

30,00 

25,00 

189,00 

740,00 

60,00 

300,00 

236,102,00 

288,00 

375,00 

475,00 

8,835.00 

370.00 

8,340.00 

105.00 

1,371.00 

3,700.00 

6,816.00 

1,140.00 

45.00 


Protem, 
pounds. 


3.48 
79.20 
1.44 
6.65 
12.76 
23.50 
43.55 


647.98 

613.20 

53.13 

53.92 

10.14 

1,417.50 

2,858.82 

3.36 

55.80 

69.65 

4.10 

2.16 

1.48 

2.70 

2.64 

295.20 

1.54 

.21 

383.48 

118.58 

46.46 

14.34 


29.87 

35.20 

196.00 

3.96 

.80 

.01 


37,04 

16.71 

62.11 

62.64 

27.95 

9,151.18 

133.00 

1.66 

3.74 

4.14 

112.70 

537.84 

6.12 

10.30 

.21 

.82 

20.79 

99.16 

8.34 

.60 

7,791,36 

2,76 

18,37 

6.65 

1,475.44 

2.22 

100.08 

9.24 

9.59 

173. eo 

245.37 

280.44 

.22 


Fat, 
pounds. 


13.92 

108.90 

.12 

6.65 

8.73 

5.00 

273.34 


53.70 

36.40 

4.83 

7.70 

.78 

113.40 

,312.28 

8.82 

7.20 

9.95 

.91 


.19 

.30 

.24 

367.97 

5.84 

.05 

164.35 

39.52 

9.59 

4.81 


37.26 

33.08 

182.00 

1.08 

1.20 


5.29 

15,00 

45,54 

89.64 

1.95 

817.07 

22.00 

1,92 

4,60 

.36 

119.14 

38.88 

1.80 

1.58 

.15 

.80 

2.64 

6.66 

12,72 

.30 

9,444.08 

2.67 

64.87 

1.42 

644.95 

.37 

6,922.20 

2.52 

1.36 

3.70 

13.63 

11.40 

.18 


Carbo- 
hydrates, 
pounds. 


647.28 
3,271.95 
70.20 
239.75 
327.93 
312.50 


60.00 

2,359.22 

1,822.80 

183.54 

177.19 

60.06 

3,754.80 


236.88 

316.20 

238.80 

33.74 

33,12 

33,12 

7,80 

50,64 

3,07 

3.63 

10.97 

2,602.24 

760,91 

380,77 

62,63 

1,123,20 

214,67 

259.77 

1,462.00 

58.32 

19.80 

.12 

355.20 

126.92 


482.30 

61,198.54 

714.00 

24.44 

55.29 

28.44 


,119.20 

13.68 

1.27 

1.77 

7.05 

144.20 

548.34 


8.10 

11,805.10 

3.21 

13.12 

42.27 

5,848.77 

31,49 


4.09 

148.06 

2,312.50 

666.96 

706.80 

5.71 


Calories. 


1,270,200 

6,524,100 

133,800 

475,180 

672,000 

630,000 

1,190,724 

108,800 

5,677,880 

4,690,000 

449,190 

451,968 

130,260 

9,853,200 

19,321,680 

483,000 

704,400 

597,000 

72,504 

64,008 

64,008 

20,400 

99,600 

2,043,850 

33,264 

20,935 

6,094,720 

1,758,996 

514,565 

163,812 

2,036,736 

595,980 

670,208 

3,750,000 

117,432 

42,200 

Pfi»  259 

660,450 

317,520 

91,622 

310,590 

479,520 

934,050 

130,976,321 

1,627,000 

57,600 

125,856 

60,588 

691,012 

10,419,840 

45,000 

27,438 

4,200 

18,000 

310,149 

1,201,760 

67,0«?0 

17,100 

74,136,028 

386,016 

322,125 

94,525 

15,929,505 

62,530 

28,439,400 

35,175 

290, P23 

4,662,000 

1,710,816 

1,837,680 

11,520 


60 


A  Dietary  Study. 


TABLE  A.— Dietary  from  July  1, 


to  December  31,  1920— Concluded. 


Articles  of  Food. 


Weight, 
pounds. 


Protein, 
pounds. 


Fat, 
pounds. 


Carbo- 
hydrates, 
pounds. 


Calories. 


Pears,  canned 

Pears,  dried 

Pineapple,  canned 

Pickles. 

Plums,  canned 

Pork,  fresh 

Pork  loins 

Potatoes,  Irish 

Potatoes,  sweet 

Prunes 

Pumpkin,  canned 

Rhubarb 

Raspberries,  canned 

Raisins 

Rice 

Salt  pork 

Salmon 

Sausage,  pork 

Sardines 

Sugar 

Shredded  wheat 

Shortening 

Sirup 

Tapioca 

Tomatoes,  fresh 

Turnips 

Tomatoes,  canned 

Water  melons 

Yeast 

Totals 

Average  for  each  of  six  months. . . . 
Amount  per  day  per  capita 

Cost  per  day  per  capita,  $0.29. 
Cost  per  thousand  calories,  $0 


378.00 
390.00 
504.00 
450.00 
462.00 
094.00 
391.00 
630.00 
624.00 
123.00 
816.00 
158.00 
222.00 
500.00 
200.00 
218.00 
384.00 
403.00 

69.00 
000.00 

81.00 
000.00 
880.00 

20.00 
,911.00 
345.00 
,697.00 
106.00 

88.00 


669,141.50 


111,523.68 
4.87 


1.13 

10.92 

2.01 

2.25 

2.31 

82  05 

60.60 

497.34 

78.73 

146.21 

6.52 

.63 

3.77 

11.50 

416.00 

12.86 

14.88 

52.39 

16.35 


.80 


107.19 
39.10 

200.36 
14.21 
10.29 


1.13 

21.06 

3.50 

1.35 

.46 

599.51 

56.69 

27.63 

33.74 


1.63 

.63 

2.22 

15.00 

15.60 

171.78 

28.80 

177.32 

8.34 


1.45 
6,000.00 


.02 

47.63 

4.34 

33.39 

7.10 

.35 


68.04 
284.31 
183.45 

12.15 
103.02 


4,061.61 

1,231,65 

5,052.50 

54,67 

3.47 

27.97 

342.50 

4,108.00 


4.43 


10,000.00 
60.91 


3,928.40 
17.60 
464.52 
247.66 
667.88 
191.86 
18.48 


130, 

637, 

359, 

31, 

198, 

2,685, 

341, 

8,399, 

2,513, 

9,510, 

122, 

9, 

66, 

703, 

8,273, 

749, 

253, 

826, 

63, 

18,140, 

134, 

24,492, 

7,080, 

32, 

1,226, 

538, 

1,719, 

405, 

53: 


032 
650 
784 
500 
660 
770 
343 
520 
928 
803 
400 
796 
600 
500 
200 
830 
440 
956 
756 
000 
217 
000 
880 
160 
833 
780 
791 
042 


29,304.98 


30,384.17 


142,481.49 


437,589,642 


4,884.16 
96.49  grams 


5,064.03 
100.11  gms. 


23,746.91 
470.21  gms. 


72,931,607 
3,188 


STATE   TRAINING   SCHOOL. 
TABLE   B. — Comparison  of  the  per  capita  use  of  some  of  the  important  staples. 

Staples.  Ounces. 

Flour,    white    9 .  44 

Corn  meal    0. 06 

Potatoes,    Irish  and  sweet 3 .  84 

Beans,   dried    1 .  44 

Sugar    and   sirup    1 .  44 

Beef .  3.24 

Pork,  fresh  and  cured 0.32 

Lard     0.64 

Sausage    0. 04 

Butterine     0.96 

Milk 27.52 

Fruit,    dried     3.24 

Fish,  fresh  and  canned 0.14 

Bread     0.06 

Table  B  is  interesting  in  that  it  shows  what  the  staple  foods  were. 
Bread,  potatoes,  beef  and  dried  fruits  made  up  most  of  the  diet.  There 
was  a  generous  use  of  milk — nearly  a  quart  per  capita  per  day.  This  is  to 
be  greatly  commended.  Only  a  detailed  study  of  the  daily  menu  will 
show  how  well  the  nutrients  mentioned  in  this  table  are  utilized  for  the 
best  care  of  the  inmates. 


state  Training  School,  61 


STATE  TRAINING  SCHOOL. 
Table  C. — Classification  of  groups  of  foods — Per  cent  of  calories  of  total  calories. 
Classes  of  foods.  Per  cent. 

Breadstuffs     36.02 

Vegetables     13 .  48 

Fruits : 6.91 

Sugar,    sirup    5.91 

Butterine,    lard 12  .  09 

Milk,  cheese,  eggs 17 .  56  ' 

Meats,  fish .      8 .  43 

The  classification  in  table  C  tells  the  source  of  the  energy  derived 
from  the  food.  It  will  be  noticed  that  breadstuffs  furnish  more  than  one- 
third  ;  next  comes  milk,  cheese  and  eggs ;  then  vegetables,  followed  closely 
by  butterine  and  lard.  The  aim  should  be  made  to  increase  as  much  as 
possible  the  use  of  fruits  and  vegetables,  for  in  an  institution  of  this  kind 
a  stimulating  diet  is  not  needed. 

STATE  TRAINING  SCHOOL. 

TABLE  D. — Per  cent  of  protein  compared  with  total  protein  from  each  of  the  following 

classes  of  foods. 

Total  protein, 

Foods.                                                                                                              pounds.  Per  cent. 

Vegetables,   fresh  and  dried 4,000.92  13.65 

Vegetables,     canned 1,435.07  4.89 

Fish     171.45  .58 

Cereals     1,976 .59  6 .  74 

Breadstuffs      9,710.58  33.13 

Meat,    fresh    3,028 .48  10 .  33 

Meat,   canned  and  salt 221.50  0.75 

Milk     7,818.96  26.68 

Fruits     568.06  1.93 

Cheese   and  eggs 357 .31  1 .  22 

Butterine     100.08  0.34 

Average  per  cent  protein:  Vegetable  sources,  60.10  per  cent;  animal  sources,  39.90 
per  cent.     Cost  per  1,000  calories,  $0,091. 

Table  D  shows  where  the  protein  comes  from.  Here  again  the  bread- 
stuffs  have  the  lead,  followed  by  milk,  vegetables  and  meat.  The  total 
protein  from  vegetable  sources,  60.34,  is  large,  and  accentuates  again 
the  fact  that  large  quantities  of  vegetables  are  used,  which  is  to  the  ad- 
vantage of  those  using  the  food. 

RECAPITULATION. 

1.  The  study  of  the  dietary  for  this  half  year  has  been  taken  up  to 
determine  the  quantity  of  food  used,  and  whether  the  nutrient  material 
was  so  distributed  as  to  be  sufficient  and  satisfactory  for  the  inmates, 
in  order  that  their  physical  health  and  vigor  raay  be  conserved. 

2.  Another  object  was  to  determine  the  relative  cost  of  the  different 
food  ingredients,  and  the  comparison  of  this  with  that  dispensed  at  other 
state  '.nstitutions. 

3.  Both  the  total  amount  of  food  used  per  day  per  capita,  as  indicated 
by  the  calories,  and  the  proportion  of  protein  and  of  fat  are  satisfactory. 

4.  The  cost  of  29  cents  is  very  moderate,  considering  the  high  cost  of 
food  on  the  market. 

5.  The  large  amount  of  milk  used  is  to  be  commended.  Not  only  is  it 
valuable  for  growth  and  nourishment,  but  its  cost  is  not  so  much  higher 
than  other  foods  as  is  often  supposed. 


62  A  Dietary  Study. 

6.  This  analysis  of  the  diet  shows  a  large  quantity  of  vegetables  used, 
which  must  be  of  great  advantage,  not  only  on  account  of  the  variety 
furnished,  but  because  a  vegetable  diet  will  improve  the  health  of  the  in- 
mates.   This  is  also  brought  out  in  table  D. 

7.  The  cost  of  1,000  calories  is  an  index  of  what  the  energy  used,  re- 
gardless of  its  source,  actually  costs.  The  figure,  91  mills,  is  very  mod- 
erate, considering  the  cost  of  living. 

8.  The  excellent  report  from  the  steward's  office,  furnished  by  Supt. 
W.  W.  Cooke,  aided  greatly  in  making  this  study  of  the  dietary. 


IX. 

STATE  SCHOOL  FOR  THE  DEAF,  OLATHE. 

(Abstract  of  Report.) 

Lawrence,  Kan.,  May  26, 1921. 

Herewith  is  presented  a  report  on  the  dietary  of  the  State  School  for 
the  Deaf  at  Olathe. 

At  my  request,  the  superintendent,  Mr.  Elwood  A.  Stevenson,  has  sent 
me  a  list  of  the  foods  used  for  the  months  of  September,  October,  No- 
vember and  December,  1920.  The  month  of  December  only  is  here  given 
as  table  A.    A  discussion  of  each  table  follows. 

As  evidence  of  the  variety  of  the  food  used,  it  is  noted  that  more  than 
75  different  articles  appear  in  table  A. 

The  advantage  of  a  dietary  covering  a  long  period  is  shown  in  the 
irregularity  of  the  following  four  months'  table  (table  B).  There  is 
evidently  some  flour  carried  over  from  one  month's  account  to  the  next. 
The  same  thing  is  true  of  the  potatoes,  beef  and  pork. 

There  is  an  important  increase  in  the  milk  used  after  September.  The 
average  of  these  months  might  be  computed,  but  it  is  not  as  definite  a 
figure  as  if  a  longer  period  were  studied.  Considering  the  single  month 
of  December  there  was  issued  6.11  ounces  of  fruit,  fresh,  canned  and 
dried,  daily  per  capita — an  abundant  quantity,  which,  while  adding  con- 
siderably to  the  expense,  would  also  tend  to  improve  the  physical  health 
of  the  inmates. 

(63) 


64 


A  Dietary  Study. 


STATE  SCHOOL  FOR  THE  DEAF. 
TABLE  A.— Dietary  for  December,  1920. 


Aeticles  of  Food. 


Weight, 
pounds. 


Protein,  Fat, 

pounds.  pounds. 


Carbo- 
hydrates, 
pounds. 


Calories. 


Apples,  canned 

Apples,  fresh 

Apple  butter 

Apricots,  canned 

Apricots,  dried 

Bacon 

Baking  powder 

Bananas 

Beans,  Lima 

Beans,  navy 

Beans,  string 

Beef,  fresh 

Beef,  dried 

Blackberries , . . 

Bologna 

Butter 

Butterine 

Cabbage 

Candy 

Carrots 

Catsup 

Celery 

Cherries,  canned 

Cheese 

Chicken 

Citron 

Corn  flakes 

Corn  meal 

Cornstarch 

Corn, canned 

Crackers,  soda 

Currants 

Dates 

Eggs 

Flour,  Graham 

Gelatin . 

Gooseberries 

Grape  fruit 

Grapenuts 

Grapes,  canned 

Ham 

Jelly 

Lemons 

Lettuce 

Life  of  wheat 

Milk 

Nuts 

Oat  flakes 

Oranges 

Oysters 

Feaches,  canned 

Peaches,  dried 

Pears,  cgnned 

Peas,  canned 

Peanut  butter 

Plums,  canned 

Pork,  fresh 

Potatoes,  Irish 

Potatoes,  sweet 

Prunes 

Pudding 

Raisins 

Rice 

Salmon 

Saratoga  wafers 

Sardines 

Sausage 

Sugar,  granulated 

Sirup 

Tapioca 

Tomat  es,  canned 

Wheat  flour 

Yeast 

Totals 

Amount  per  day  per  capita 


216.00 

250.00 

180.00 

336.00 

25.00 

834.00 

10.00 

8.00 

187.00 

200.00 

90.00 

1,466.00 

4.00 

180.00 

111.50 

8.00 

600.00 

215.00 

37.00 

250.00 

48.00 

36.00 

192.00 

104.00 

106.00 

4.00 

18.00 

25.00 

48.00 

224.00 

190.00 

8.00 

2.00 

192.00 

25.00 

.75 

32.00 

48.00 

18.00 

64.00 

333.00 

60.00 

24.00 

3.50 

63.00 

10,344.50 

20.00 

90.00 

115.00 

15.00 

90.00 

ZOO 

90.00 

192.00 

50.00 

126.00 

343.50 

1,920.00 

250.00 

75.00 

25.00 

56.00 

25.00 

120.00 

36.00 

32.00 

200.00 

1,200.00 

120.00 

5.00 

236.00 

3,600.00 

8.00 


26,409.75 


.67 


0.43 
.75 
2.16 
3.02 
1.17 
79.23 


33.84 

45.00 

.99 

212.57 

1.05 

1.44 

20.29 

.08 

7.20 

3.01 


2.25 

.72 

.32 

2.22 

29.95 

14.52 

.02 

.99 

2.30 


6.27 

18.60 

.19 

.03 

22.84 

3.32 

.68 

.41 

.28 

2.07 

.76 

58.27 

.72 

.16 

.03 

6.93 

341.36 

.98 

15.03 

.69 

1.32 

.63 

2  35 

.27 

6.«0 

14.65 

1.26 

25.76 

34.56 

3.50 

1.35 

.82 

1.28 

2.00 

23.40 

3.52 

7.58 

26.00 


.20 

2.80 

392.00 

.93 


1,^ 


93  grams 


1.72 

.75 
.18 


.25 


495.; 


.03 

2.80 

3.60 

.09 

246.26 

.27 

3.78 

21.96 

6.80 

498.00 

.43 


.50 
.96 
.03 
.18 
37.32 
13.03 
.06 
.27 
.47 


2.68 

17.20 

.13 

.05 

17.85 

.55 


.48 
.04 
.18 
.06 
61.60 


.11 


413. 
3. 


.5' 

.27 

.36 

23.25 


58.23 
1.92 
1.50 


1.68 
.17 
9.00 
3.26 
3.87 
88.00 


.44 

35.00 

.03 


2,219. 


139  grams 


80.35 
27.00 
105.30 
58.12 
15.62 


3.00 

1.14 

123.23 

119.20 

3.42 


101.52 


10.32 
35.52 
18.50 
5.90 

.93 
40.50 

.31 


3.12 

14.58 

18.85 

43.20 

42.56 

138.80 

5.93 

1.41 


17.85 


6.11 
4.08 
15.88 
37.44 


35.88 

1.41 

.87 

48.06 

517.22 

.70 

59.58 

9.77 

.58 

9.72 

31.25 

16.20 

18.81 

8.55 

25.32 


282.24 
54.75 
46.65 
7.05 
38.36 
19.75 


26.30 


2.20 

1,200.00 

96.60 

4.40 

9  44 
2,62L50 

1.68 


6,294.53 


333  grams 


157,680 

52,800 

200,700 

114,240 

31,500 

2,165,898 

5,440 

2,320 

296,582 

312,800 

8,370 

1,436,680 

3,040 

2C3,320 

14,941 

27,904 

2,146,000 

25,800 

66,045 

38,750 

12,720 

2,448 

79,680 

207,376 

79,606 

5,948 

29,358 

40,325 

78,336 

99,680 

356,250 

11,672 

2,832 

114,240 

40,675 

1,246 

16,400 

8,112 

30,294 

71,360 

367,309 

68,100 

3,360 

252 

106,155 

3,248,173 

17,180 

162,270 

19,435 

5,025 

19,170 

64,500 

30,960 

48,192 

137,050 

49,770 

843,292 

583,680 

111,750 

87,075 

18,000 

78,792 

39,775 

79,200 

67,500 

29,568 

410,400 

2,176,800 

174,120 

8,040 

24,308 

5,610,500 

4,880 


23,193,949 


,225 


state  School  for  the  Deaf. 


65 


STATE  SCHOOL  FOR  THE  DEAF. 

TABLE  B. — Per  capita  use  of  some  of  the  important  staples. 


Staples. 

September, 
ounces. 

October, 
ounces. 

November, 
ounces. 

December, 
ounces. 

Flour,  white  and  Graham 

7.15 

.04 

8.92 

.70 

3.05 

2.84 

2.54 

.72 

.35 

1.50 

15.66 

.22 

.43 

8.89 

9.26 

.04 

12.59 

.44 

2.52 

3.28 

2.04 

.91 

•.44 

1.40 

30.12 

7.84 

.04 

Potatoes,  Irish  and  sweet 

2.88 

1.13 

3.10 

4.80 

3.07 

.88 

.44 

1.36 

29.52 

.01 

.49 

4.81 

Beans  dried                                . . . 

.84 

2.88 

3.26 

3.36 

Lard 

.68 

Butter  and  butterine 

1.34 

Milk,  fresh 

23.00 

.48 

Fish,  canned 

.24 

.36 

STATE  SCHOOL  FOR  THE  DEAF. 
TABLE  C. — Per  capita  use  of  food  for  four  months. 


Month,  1920. 

Weight 
of  food, 
pounds. 

Protein, 
grams. 

Fat, 
grams. 

Carbo- 
hydrates, 
grams. 

Calories. 

September           .    . . 

3.65 
4.55 
5.22 
3.67 

78 
111 
110 

93 

Ill 
167 
159 
139 

393 
459 
492 
333 

3,192 

October 

3,814 

November 

December 

3,865 
3,225 

STATE  SCHOOL  FOR  THE  DEAF. 
TABLE  D. — Total  attendance,  population,  cost,  and  cost  per  day. 


Period  of  Study,  1920. 

Total 
popula- 
tion. 

Total 
attend- 
ance. 

Total 

cost 

per  month. 

Cost 

per  day 

per  capita. 

September  .  .    . 

227 
230 
230 
230 

6,810 
7,190 
6,900 
7.190 

$2,348.49 
3,061.11 
2.778.36 
2.428.86 

$0,345 

October 

.425 

November 

.402 

December 

.335 

Table  C  shows  that  the  average  protein  (98  grams  per  day)  is  suffi- 
cient for  inmates  of  this  class,  while  the  3,524  calories  afforded  by  the 
food  is  certainly  abundant  and  might  be  slightly  decreased  without  loss 
to  physical  well-being. 

Table  D  refers  to  the  cost  per  day,  and  is  not  high  considering  the 
high  market  price  during  this  period. 

Table  E  shows  where  the  energy  of  the  food  comes  from.  Breadstuffs 
furnish  more  than  a  quarter,  and  the  remainder  is  distributed  between 
the  other  food  products.  Butter  and  its  substitutes  seem  to  furnish  a 
large  amount  of  energy,  but  it  should  be  remembered  that  the  fuel  value 
of  fats  is  very  high.  Fruits,  although  abundant,  do  not  furnish  much 
energy,  as  they  contain  so  much  water.  Fruits  canned  in  sirup,  however, 
afford  considerable  nutriment  on  account  of  the  high  fuel  value  of  sugar. 


5 — Dietary — 575 


66 


A  Dietarij  Study. 


STATE  SCHOOL  FOR  THE  DEAF. 
TABLE  E. — Classification  of  groups  of  food. — Per  cent  of  calories  of  total  calories  in  the  groups  given. 


Classes  of  Foods. 


September, 
per  cent. 


October, 
per  cent. 


November, 
per  cent. 


December, 
per  cent. 


Breadstuffs 

Vegetables 

Fruits 

Sugar,  sirup 

Butter,  lard,  butterine 
Milk,  cheese,  eggs. . . . 
Meats,  fish 


25.37 
10.65 
6.69 
10.60 
18.74 
10.07 
17.34 


24.44 
6.40 
6.62 
9.22 
13.61 
16.19 
19.84 


29.14 
10.24 
6.96 
7.46 
13.98 
16.54 
16.19 


28.31 
7.34 
9.24 

10.13 
8.94 

15.39 

21.43 


STATE  SCHOOL  FOR  THE  DEAF. 

TABLE  F. — Showing  the  total  number  of  pounds  and  the  per  cent  of  protein  obtained  from  each  of  the 

following  sources. 


SoxmcE. 

September. 

October. 

November. 

December. 

Pounds. 

Per  cent. 

Pounds. 

Per  cent. 

Pounds. 

Per  cent. 

Pounds. 

Per  cent. 

Vegetables,  fresh  and  dried 

145.69 
42.23 
38.56 

384.33 

177.69 
90.27 

218.79 
31.36 
43.15 

12.42 
3.60 
3.29 

32.79 

15.16 
7.70 

18.66 
2.67 
3.68 

141.63 

28.16 

34.00 

521.49 

314.21 

205.85 

437.86 

23.62 

54.47 

7.99 

1.59 

1.92 

29,44 

17.74 

11.62 

24.72 

1.33 

3.07 

158.83 

23.26 

20.60 

520.83 

321.85 

118.87 

428.88 

24.79 

61.34 

9.45 

1.38 

1.22 

31.02 

19.15 

7.08 

25.54 

1.47 

3.65 

122.51 
32.33 
32.30 
448.71 
252.85 
185.52 
341.36 
22.63 
60.07 

8.17 
2.15 

Fish     .                       

2.15 

29.95 

Meat,  fresh                       

16.87 

12.35 

Milk                                  

22.79 

Fruit,  fresh,  canned,  dried 

Butter,  cheese,  egms,  butterine 

1.51 
4  01 

Total  calories  for  four  months 99,028,235 

Total  attendance  for  four  months 2  8,090 

Total  cost  for  four  months $10,616 .  82 

Cost  per  thousand  calories $0 .  107 

Average  per  cent  of  proteins  from  animal  sources 56% 

Average  per  cent  of  proteins  from  vegetable  sources 44% 

Finally,  table  F  tells  where  the  protein  comes  from.  About  one-third 
comes  from  cereals  and  breadstuffs.  Meat,  milk  and  eggs  furnish  nearly- 
half  the  protein. 

A  study  of  the  sources  of  the  protein  shows  that  56  per  cent  is  from 
animal  and  44  per  cent  from  vegetable  proteins.  Ordinarily  we  should 
say  that  it  would  be  more  satisfactory  if  there  were  more  protein  obtained 
from  vegetable  sources  than  from  animal.  In  this  case,  however,  the  high 
animal  protein  is  probably  due  to  the  large  amount  of  milk,  and  it  is  of 
great  advantage  to  the  inmates  to  be  able  to  have  so  much  milk.  A  con- 
venient method  for  comparing  the  cost  of  different  dietaries  is  by  com- 
paring the  cost  per  thousand  calories,  and  10.7  cents  per  thousand  is  not 
excessive. 

RECAPITULATION. 

1.  There  seems  to  be  more  difficulty  in  the  smaller  institutions  to 
check  up  the  actual  food  used  per  month  or  per  day  than  in  the  larger 
ones,  so  this  dietary  is  not  as  satisfactory  as  one  covering  six  months  or 
an  entire  year. 

2.  The  protein  used  in  this  institution  appears  to  be  sufficient  for  this 
class  of  inmates. 


state  School  for  the  Deaf.  67 

3.  The  energy  as  shown  by  the  3,524  calories  per  day  per  capita  is 
possibly  somewhat  in  excess  of  the  needs  of  persons  not  engaged  in  active 
physical  work. 

4.  The  cost  of  the  food  is  not  excessive. 

5.  The  large  amount  of  milk  used — ^nearly  a  quart  in  October  and 
November — is  very  satisfactory.  It  will  add  little  to  the  expense  and 
much  to  the  health  to  keep  the  consumption  of  milk  as  high  as  possible. 
In  November  more  calories  were  afforded  by  the  milk  than  by  any  other 
product  except  wheat  flour. 

6.  In  general  this  dietary  shows  the  use  of  abundant  food,  fairly  well 
distributed  as  to  materials.  It  is,  of  course,  important  that  the  daily 
menu  be  so  varied  that  it  is  agreeable  to  the  taste  in  order  to  keep  up  the 
appetite,  and  that  it  affords  a  well-balanced  ration.  Fresh  vegetables  and 
fruits  should  be  used  abundantly  when  they  can  be  procured.  It  is  ad- 
visable to  keep  the  meat  consumption  low. 

Note. — A  partial  study  of  the  dietary  at  the  State  Orphans'  Home  in  Atchison  was 
also  made,  but  the  methods  of  issuing  the  provisions  to  the  kitchens  made  it  difi&cult  to 
arrive  at  reliable  conclusions  in  regard  to  the  daily  use  of  food,  so  that  a  further  study 
was  deemed  advisable  before  making  a  final  report. 


68 


A  Dietary  Study, 


COMPARISON  OF  THE  DIETARIES  OF  NINE  KANSAS 
INSTITUTIONS. 

1.  These  dietaries  cover  different  periods,  from  July,  1917,  to  De- 
cember, 1920. 

2.  The  character  of  the  inmates  is  entirely  different  in  the  different  in- 
stitutions. 

3.  The  three  Ijospitals,  that  of  Topeka,  Osawatomie  and  Parsons 
(which  is  especially  for  epileptics),  may  be  compared  in  some  respects. 
It  is  noticed  that  the  average  protein  used  is  quite  similar  in  the  Topeka 
and  Osawatomie  institutions,  viz.,  83-87.  The  Parsons  hospital  is  higher 
(101),  and  very  reasonably  so.  There  happens  to  be  a  remarkable  agree- 
ment between  the  calories  used  at  the  two  hospitals,  viz.,  2,911-2,927, 
while  the  Parsons  institution  is  higher,  as  it  should  be. 

4.  The  high  energy  value  of  the  food  used  at  Lansing  has  already  been 
referred  to,  and  is  probably  higher  than  necessary.  Comparing  this, 
however,  with  some  southern  prisons,  it  is  noticed  that  the  calorie  value 
of  the  food  in  1915  in  the  Texas  prison  farms  was  5,429  and  the  Louisiana 
farms  4,196.  In  the  South  the  staple  foods  are  bacon,  beans,  corn,  flour, 
molasses,  sugar  and  rice. 

5.  Comparing  the  Industrial  School  for  Girls  at  Beloit  with  the  In- 
dustrial School  for  Boys  at  Hutchinson,  as  these  two  institutions  are 
somewhat  alike,  it  will  be  noticed  that  the  boys  have  a  somewhat  higher 
protein  diet  of  the  two  institutions,  but  if  we  allow  the  girls  83  per  cent 
of  the  amount  given  the  boys  (a  proportion  that  is  recommended  by  many 
authorities),  the  amounts  furnished  at  the  two  institutions  agree  very 
satisfactorily.  Recent  investigation  by  Doctor  Gephart  and  others  have 
shown  that  the  amount  of  food  utilized  by  the  growing  boy  is  entirely  be- 
yond belief. 

COMPARISON  OF  INSTITUTIONS. 
TABLE  I. — Comparison  of  the  per  day  per  capita  use  of  some  of  the  important  staples  at  nine  state  institutiona. 


Institutions. 


Penitentiary,  Lansing 

Industrial  School,  Hutchinson . . . 

Hospital,  Osawatomie 

Industrial  School,  Beloit 

Hospital,  Topeka 

Hospital,  Parsons 

School  for  Blind,  Kansas  City. . . 

Training  School,  Winfield 

School  for  Deaf,  Olathe 


Flour, 


11.84 

14.83 
8.96 
6.08 
8.04 
7.28 
5.12 
9.44 


Pota- 
toes, 
oz. 


17.13 

16.23 
8.71 

11.92 
7.43 
8.57 

16.06 
3.84 
7.30 


Sugars, 


3.48 
2.21 
1.38 
1.75 
1.44 
1.89 
2.98 
1.44 
2.89 


Beef, 


9.76 
5.49 
4.33 
1.91 
5.35 
4.43 
2.66 
3.24 
3.54 


Milk, 


11.88 
10.19 
12.93 
31.22 
12.24 
26.34 
16.49 
27.52 
24.55 


Butter 
and  oleo, 


.76 

.62 

1.03 

1.34 

.72 

.80 

.90 

.96 

1.40 


Pork, 


3.79 

1.89 

1.17 

.67 

.66 

.25 

1.07 

.32 

2.75 


Sau- 


4.03 
.89 
.29 
.00 

.11 
.23 
.04 

.48 


!•  •       -• 


A  Dietary  Study. 


69 


COMPARISON  OF  INSTITUTIONS. 
TABLE  II. — Per  capita  comparison  of  the  average  dietaries  of  nine  state  institutions. 


Institutions. 

Weight 
of  food, 
pounds. 

Protein, 
grams. 

Fat, 
grams. 

Carbo- 
hydrates, 
grams. 

Calories. 

Cost. 

Cost  per 

1,000 
calorics. 

Penitentiary,  Lansing, 

July,  1917.  to  January,  1918 

5.93 

147 

223 

673 

5,389 

$0,395 

$0,074 

Industrial  School,  Hutchinson, 

July,  1917,  to  March,  1918 

4.49 

122 

108 

639 

4,032 

.270 

.068 

Hospital,  Osawatomie, 

July  1917  to  May,  1918         

3  27 

83 

102 

412 

2,911 

.219 

.076 

Industrial  School,  Beloit, 

September,  1917,  to  September,  1918. 

4.58 

91 

106 

430 

3,113 

.175 

.058 

Hospital,  Topeka, 

October,  1917,  to  October,  1918 

3.40 

87 

96 

418 

2,927 

.236 

.081 

Hospital,  Parsons, 

October,  1918,  to  October,  1919 

4.70 

101 

109 

481 

3.355 

.330 

.099 

Blind,  Kansas  City, 

January,  1919,  to  January,  1920 

3.67 

72 

92 

366 

2,668 

.380 

.115 

Training  School,  Winfield, 

July,  1920,  to  January,  1921 

4.87 

96 

100 

470 

3,188 

.290 

.091 

Deaf,  Olathe, 

September,  1920,  to  January,  1921 .  . 

4.27 

98 

144 

419 

3,524 

.377 

.107 

6.  There  are  so  many  other  items  that  have  to  be  considered  under  the 
head  of  cost,  that  comparisons  are  difficult.  Referring,  however,  to  table 
II,  a  comparison  of  state  institutions,  the  United  States  Department  of 
Labor,  Bureau  of  Labor  Statistics,  reports  the  following  index  numbers 
for  retail  prices  of  the  principal  articles  of  food  in  the  United  States. 
Starting  with  100  as  the  average  for  1913,  the  figures  are  as  follows: 

1913 100  1917 146 

1914 102  1918 168 

1915 101  1919 /186 

1916 114  1920 203 

This  shows  a  gradual  rise  in  cost  from  1917  to  1921,  the  period  of  the 
study.  Applying  this  to  the  cost  for  1,000  calories,  the  food  at  Lansing 
which  cost  .074  cents  in  1917  should  cost  .103  cents  in  1920.  This  in 
general  agrees  with  the  added  cost  in  the  later  years. 

7.  It  is  hoped  that  a  comparison  of  the  dietaries  of  the  institutions 
may  be  of  value  to  the  superintendents,  and  may  help  them  to  supply  still 
more  fully  at  each  institution  just  the  right  proportions  of  the  different 
foods  adapted  to  the  health  and  well-being  of  the  inmates.  It  is  only 
by  mutual  cooperation  that  we  can  hope  to  improve  the  service. 

8.  We  fully  realize  that  even  with  sufficient  wholesome  food  purchased 
by  your  Board  of  Administration,  unless  the  greatest  care  is  taken  in  the 
menu  for  each  day,  and  even  for  the  individual  meals,  the  best  results 
cannot  be  attained.  To  serve  only  starchy  food  for  one  meal  and 
an  overbalanced  protein  menu  for  the  next  will  not  satisfactorily  nourish 
the  body. 


70  A  Dietary  Study, 

9.  The  place  and  manner  in  which  the  food  is  served  have  much  to 
do  with  stimulating  the  appetite  and  aiding  digestion.  A  damp,  poorly 
lighted  basement  should  never  be  used  as  a  dining  room.  Circumstances 
have  made  this  necessary  in  some  instances,  but  clean,  well-lighted  dining 
rooms  should  be  provided. 

10.  My  thanks  are  especially  due  to  Miss  Harriett  M.  Stevenson,  a 
graduate  of  the  department  of  home  economics  of  the  University  of 
Kansas,  for  her  very  efficient  service  in  working  out  the  details  of  this 
work.  The  cheerful  assistance  offered  by  the  superintendents  of  the 
various  institutions  in  furnishing  the  data  for  this  study  is  also  thank- 
fully acknowledged.  Respectfully  submitted, 

E.  H.  S.  BAILEY. 


n 


,*  •       •  •' 


J.V1H1^C1» 


Syracuse,  N.  Y, 
PAT.  JAN.  21, 1908 


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